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Epidural Steroid Injections

Epidural Steroid Injection Medicated solution is injected

Many patients have heard about epidural injections (commonly known as epidurals) because they, their friends, or their spouses have had epidurals for labor delivery. Epidurals are currently the standard pain management for labor delivery in the U.S. and most developed countries.

What Are Epidural Injections?

Epidural injections mean delivery of medications to the epidural space in the spinal cord. Similar to the brain, the spinal cord is well protected with spinal fluid, which is contained by a few layers of membranes. In the spinal canal, there is a loose space between the outside layer of the membranes (called dura) and surrounding bone structures called the epidural space, where spinal nerve roots exit the spinal cord and spinal canal to reach every part of the body.

Epidural steroid injections include a long-lasting steroid and a local anesthetic. The steroid reduces the inflammation and irritation and the anesthetic interrupts the pain signal transmission. The medicine is then distributed throughout the spine to reduce inflammation and irritation. The entire procedure usually takes less than fifteen minutes.

Spinal conditions commonly treated with epidural steroid injections normally involve pain caused by the following:

  • Radicular pain/radiculitis: Pain that radiates from an irritated spinal nerve root
  • Nerve compression in the neck (cervical spine) and the lower back (lumbar spine)
Epidural Steroid Injection Lower back and radiating leg pain

Other conditions can be treated with epidural steroid injections include:

  • Degenerative disc disease
  • Spinal stenosis
  • Herniated discs spondylosis
  • Sciatica

Epidural steroid injections are simple and safe procedures. They are done under x-ray guidance and with light sedation. Patients are normally released after 1-2 hours and can return to their normal work and activities the next day, if sedation is used.

What Are the Risks of Epidural Injections?

Although epidural steroid injections are considered safe and are one of the most commonly performed spinal procedures, there are risks associated with the procedure. The major risks associated with the injections include bleeding, infections, post-dural puncture headache, and nerve damage.

Some of the potential side effects of steroids include elevated blood sugar levels, weight gain, arthritis, and stomach ulcers. Before receiving an epidural steroid injection, all patients should be assessed for potential risks.

Patients who have an allergic reaction to any anesthetics, are on blood thinning medications, have an active infection, or are pregnant should consult with their pain physician before receiving the injections.