Epidural Steroid Injections

An epidural steroid injection is perhaps the single most useful intervention available in the modern interventional pain clinic.

Epidural injections are effective in treating many painful conditions, including intervertebral disc pain, acute herpes zoster, postherpetic neuralgia, complex regional pain syndrome, radicular pain in pregnancy, cancer pain and post-surgical pain. Epidural therapy facilitates rehabilitation efforts and may allow patients to participate more fully in physical therapy and behavioral health programs.

Inflammation as a Source of Pain

Research has identified that inflammation within and around neural structures is common in painful conditions. Neural inflammation has been shown to sensitize pain processing and increase the firing of pain neurons within the spinal nerve roots and spinal cord and it may lead to the development of chronic pain. Epidural injections are a safe and effective method to “put out the fire” of inflammation.

Epidural Injections Deliver Medication Directly to the Targeted Tissues

The epidural space allows unique access to the spinal cord and nerve roots at every level of the spine. Epidural steroid injections are a safe, low-risk way to deliver a variety of medications directly to the nervous system. Medications used alone or in combination include steroids, local anesthetics and opioids. Once delivered into the epidural space, these medications may block pain impulses, stabilize irritated nerves, reduce swelling and reverse the inflammatory changes and “spinal cord wind-up” that take place within the nervous system when pain persists.

An Extension of Conservative Care

Epidural steroid and local anesthetic injections may effectively decompress the spinal canal by shrinking swollen soft tissues, thereby relieving symptoms without surgery while the body reabsorbs herniated disc material over time. Since persistent inflammation may cause pressure damage to nerves and result in fibrosis and the formation of scar tissue within the spinal column, reversal of inflammation should be a prime goal of therapy. Spinal injections are considered an extension of conservative care by many spine specialists and are typically performed in a series of three injections at two-week intervals, if symptoms are persisting.

Although rare, risks of epidural steroid injection procedure may include infection, allergic reaction to the medication, spinal headache, nerve damage, spinal cord injury and prolonged increase in pain.

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