Epidural steroid injections are a localized pain treatment method for low back pain and sciatica caused by inflammation from slipped, herniated, or bulging discs. The injection contains a steroid and a local anesthetic, providing temporary relief for a few days to a year. It is often used as a first step in treating back pain and can provide a window of opportunity for physical therapy.
For anyone who has suffered from low back pain or sciatica, they can attest that it can be extremely debilitating. Pain relief is necessary to function normally, and many low back pain sufferers find it in the form of an epidural steroid injection. Many people automatically associate an epidural with the pain medication given to women in labor. In fact, the only thing they have in common is that a pain reliever and a steroid are administered into the epidural space of the spine.
An epidural steroid injection is primarily used for pain relief for people who experience low back pain, which is pain in the lower lumbar region of the back, or sciatica, which is also called radicular pain. Pain in the lower back is typically caused by inflammation from slipped, herniated, or bulging discs. Sciatica, which manifests as sharp, shooting pains in the lower back and legs, is also due to inflammation pressing on the nerves in the back.
Epidural steroid injection has been used since the mid-20th century as a nonsurgical option for pain relief. While typically temporary relief — anywhere from a few days to a year — it can provide a window of opportunity for the patient to begin physical therapy, which often includes a regimen of stretching and back-strengthening exercises.
The advantage of epidural steroid injection is that it is a localized pain treatment method, targeting the specific location of the inflammation. The injection typically contains a steroid, such as cortisone, methylprednisdone, or dexamethasone, that calms inflammation. A local anesthetic such as lidocaine is also injected for temporary pain relief. Occasionally, a saline solution will be added to dilute the medications and to flush out inflammatory agents around the inflammation. The needle is inserted, with the help of an x-ray, into the epidural area. The epidural area encapsulates the dural sac, which in turn surrounds the spinal cord, nerves, etc.
Your neurologist, orthopedic surgeon, or anesthetist can give you an epidural steroid injection as the first step in treating back pain. Depending on the severity of the pain and inflammation, you may initially get a round of three shots. Epidural steroid injection is successful in treating pain about half the time, while others may experience no relief or little impact on their pain.
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