What Does An Epidural Do For Lower Back Pain

Cervical Epidural Steroid Injections Can Bring Neck And Arm Pain Relief

A dysfunction in your cervical spine can lead to pain that radiates through your shoulder and down your arm. If you have this type of neck and arm pain, a cervical epidural steroid injection may help provide short-term relief. Read on to learn more about this common procedure.

Watch:Cervical Epidural Steroid Injection Video

What Kinds Of Injections Can Be Used For Back Pain

Back pain is a debilitating condition that can impact you negatively. If you are diagnosed with back pain, your physician may take key steps to ensure that you are relieved of back pain quickly and effectively. Normally, the doctor would consider exercise, physical therapy, and medication as the available treatment options.

However, to ensure that you are relieved of back pain effectively, your doctor may include injections that help ease the pain and inflammation. These injections are imperative because they consist of a steroid and numbing medicine, which set out to treat any inflammation or damage to a nerve and spinal stenosis.

Is Increased Pain After Lumbar Epidural Steroid Injection Normal

Epidurals are one of the most effective ways of treating pain and other issues in the spinal column. As a minimally-invasive method of delivering drugs and medication straight to the body, these injections play a vital role in keeping many back-related conditions like spinal stenosis and sciatica manageable. Epidural steroid injections have seen marked success in treating acute and chronic pain, with long-term results.

But what if theres increased pain after a lumbar epidural steroid injection? Typically this indicates post-injection pain or sensitivity. This is a mild side-effect that should subside within a day, and shouldnt be too painful for you. Any deviation from this characteristic should be taken as the beginning of a serious complication and reported immediately to a doctor.

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What Are The Risks Of An Epidural Steroid Injection

An epidural steroid injection generally causes no problems. If you do have side effects, they may include:

• “Steroid flush,” or flushing of the face and chest, with warmth and an increase in temperature for several days
• Sleeping problems
• In rare instances, pain that actually increases for several days after the procedure

Serious complications are rare but can include:

• Allergic reaction

What Are The Risks And Side Effects

Overall, this procedure has very few risks. However, as with any procedure, there are some risks and side effects you should know about. Commonly encountered side effects are increased pain from the injection , rarely inadvertent puncture of the sack containing spinal fluid , infection, bleeding, nerve damage, or no relief from your usual pain. Side effects of the injected steroid are generally temporary and may include feeling sweaty and red faced for a few days, temporary weight gain, a short term increase in blood sugar if you take medication for diabetes your doctor may need to advise you about medication adjustment, you can discuss the steroid medication more completely when you come in for the procedure. Some people experience flushing, sweatiness and/or palpitations for few days afterwards.

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Alternative Treatments For Back Pain

Reduced pain can lead to more involved physical therapy, greater enjoyment of life, and ability to return to tasks that werent possible due to symptoms. This is why many doctors following the conventional path focus on pain relief.

There may be an option that offers not only pain relief, but treatment of the underlying condition as well. The field of Regenerative Medicine seeks to use the bodys own naturally occurring healing cells to enhance the recovery process. CELLAXYS offers two types of Regenerative Therapy:

• Mesenchymal Stem Cell Therapy: mesenchymal stem cells are located throughout the body, and contain the ability to help cells regenerate once they have been damaged. Cells are procured from the bone marrow. The cells are then processed and injected into the area where pain is most intense. Increasing the amount of regenerating cells can help damaged cells recover while simultaneously reducing pain.
• Platelet-Rich Plasma Therapy: blood cells contain many important components, one of which is called platelets. These cells contain proteins and healing factors that can reduce inflammation and call to other healing cells such as mesenchymal stem cells. The procedure of receiving PRP therapy is similar to that of mesenchymal stem cell therapy. Once blood is drawn from the patient it is placed in a centrifuge that helps to concentrate the platelets. The solution is then injected into the problem area.

What Is An Epidural Steroid Injection

The word epidural simply means the space around your spine. The steroid is cortisone, an anti-inflammatory agent, and its usually mixed with an anesthetic.

Dr. Ngu injects the medication into the epidural area, the fat-filled column that surrounds your fluid-filled spinal sac and protects your spinal nerves. The anesthetic has an immediate numbing effect that brings you quick relief, but the steroid wont kick in for a few days.

The main function of the epidural steroid injection is to reduce the swelling thats responsible for your back pain.

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What Conditions Do You Treat With Epidural Steroid Injections

Epidural steroid injections arent used to treat a specific condition. Rather, the injection acts as an anti-inflammatory that helps reduce the nerve irritation causing your pain.

Changes in the tissues in your spine that surround nerve roots can compress or pinch your nerves as they travel through or exit your spine. These conditions include:

• Herniated discs
• Bone spurs
• Narrowing of the spinal canal

There is certainly the possibility that the anti-inflammatory action of the epidural steroid injection can help prevent pain as your body recovers from an injury. And because steroid injections typically include an anesthetic, you may feel immediate pain relief that lasts several hours to days.

Again, however, just as we may recommend aspirin to reduce your fever without curing your cold, we consider an epidural steroid injection only part of your treatment plan.

What Do I Do If Epidural Did Not Work For Lower Back Pain

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Can Getting An Epidural Cause Back Problems

Theres a common belief that getting an epidural will lead to back pain, but its very rare for an epidural to cause long-term or chronic back problems.

Its normal to experience temporary back pain or tenderness at the site of your epidural. This usually goes away within a few days.

This belief likely stems from the fact that many people who go through childbirth experience back pain after labor and delivery whether theyve had an epidural or not. This is because the bones and ligaments in your pelvis are shifting back into their original positions from before your pregnancy, which can cause back pain and discomfort.

What Are Epidurals Used For

Your healthcare provider may recommend an epidural procedure for the following situations:

• To provide pain relief for labor and childbirth.
• To provide anesthesia for certain surgeries as an alternative to general anesthesia.
• To provide pain relief after certain surgeries.
• To manage certain causes of back pain and other forms of chronic pain .

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What Happens During An Epidural Injection

At the hospital, your doctor will check that youre well and still happy to go ahead with the procedure. You may be asked to change into a gown. When theyre ready to start, your doctor will ask you to lie down on a special table. They may position you on either your front or your side.

Your doctor will usually place a cannula in the back of your hand before carrying out the injection. This is in case you need any medication during the procedure. Theyll then carefully clean and prepare the area on your back where you’re having the injection, using an antiseptic solution. Your doctor will inject a local anaesthetic to numb the area. This may sting a little.

Your doctor will guide the epidural needle to the right area in your back using real-time X-ray images . Theyll usually inject a type of dye, called contrast, to check when the needle is in the right position. Once the needle is in position, your doctor will slowly inject the medication into the epidural space surrounding your spinal cord. You might feel some pressure when you have the injection, but it shouldnt be painful. Let your doctor know if you do feel any discomfort though.

It will only take a few minutes to give you the epidural injection but it may take longer to have imaging such as X-rays. It might take around 30 minutes to complete the procedure.

Lumbar Epidural Spinal Injection

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How Painful Is A Lumbar Epidural Steroid Injection

Everyone responds to the procedure differently. In general, a lumbar epidural steroid injection can be a bit uncomfortable, but it shouldnt be painful. You can ask your doctor for a mild sedative to relax you before the procedure.

Your doctor will first inject a local anesthetic into the skin on your back to numb the area. The injection might cause a mild burning or stinging sensation.

Youll likely feel some pressure when your doctor inserts the needle into the epidural space to inject the steroid medication. If you do feel any pain, your doctor can give you more of the local anesthesia to relieve it.

Questions To Ask Your Doctor

Have a think about any questions you would like to ask your doctor before you decide whether to have an epidural spinal injection or not. Here are some example questions you might like to ask.

• What other treatment options do I have to relieve my pain?
• What can I expect to happen after Ive had my epidural injection?
• Will I be able to exercise after the injection? Are there any types of exercise that it’s best not to do?
• Should I have physiotherapy or other some rehabilitation after having my epidural injection?
• How can I tell if my epidural injection has worked? How long will it take until I know if it’s worked?
• What is the likelihood of the procedure working? How long will the effects last?
• How will you reduce the risk of complications?

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Candidates For Epidural Injections

Epidural injections . generally arent recommended if you have an acute sprain or relatively mild injury that will likely resolve on its own. Instead, this treatment is reserved for long-term, chronic back pain caused by certain conditions that can irritate the nerves running through your spinal canal and nerve root canal.

Conditions that may warrant relief from epidural steroid injections include:

How Epidural Steroid Injections As Back Pain Relief Work

For people suffering from chronic low back pain, receiving an epidural steroid injection can significantly provide immediate pain relief and improve body functions.

Doctors typically recommend this procedure, in conjunction with physical therapy, to alleviate pain from:

• Herniated discs that damage and press nerves causing pain
• Spinal stenosis or the narrowing of the spinal canal
• Failed back surgery syndrome
• Bone spurs due to joint damage associated with osteoarthritis
• Other injuries to spinal nerves, vertebral column, and surrounding tissues

Epidural steroid injections involve injecting steroids and anesthetics into the inflamed nerve roots within the epidural space.

The steroid reduces inflammation in the area with back pain while the anesthetics interrupt the pain-spasm cycle. The combination of the two helps with the pain management abilities of other areas of the spine.

One to two injections with 1-4 week intervals can give a satisfactory effect to patients with mild low back pain. Meanwhile, those with chronic conditions can get the injections at 3-6 months intervals.

The length of pain relief varies, lasting for weeks or years. Its ideal to receive epidural injections together with exercise programs such as physical therapy to reinforce back muscles and prevent future inflammation.

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Causes Of Nerve Compression

Common causes of pinched nerves include disc protrusions into the nerve space , arthritic facet joints with resultant narrowing of the spinal canal, and bone spurs. Less often, scar tissue that has formed from a previous surgery can cause nerve impingement and pain.

Nerves exit the spinal cord through the epidural space. Often, this space is utilized to deliver medicine in close proximity to the spinal nerves. The most effective medications include local anesthetics and , which help reduce swelling and inflammation that can lead to pinched nerves.The location of key spinal structures, such as the facet joints and nerve structures, can broaden your understanding of your diagnosis and how a spinal epidural injection works. Photo Source: Shutterstock.com.

Try Conservative Measures First To Control Pain And Know The Limits And Risks Of Cortisone Shots If You Choose To Try It

Most people who suffer with back pain already know the drill: time heals this wound. Over weeks to months, the pain will calm down, and you will slowly return to your normal life. In the meantime, try to stay as active as possible and rely as much as possible on over-the-counter pain relievers to help avoid needing cortisone shots. Doctors call these shots corticosteroid injections.

But for some, these conservative measures may not relieve the agony soon enoughespecially if the problem is back pain caused by irritated spinal nerves. After a few weeks, just getting to the bathroom may start to feel like Napoleon’s winter march in Russia. At that point, you may be offered a cortisone injection to calm the war zone in your lower back.

Even for nerve-related back pain, guidelines discourage hasty intervention with cortisone shots. “You would do less invasive, less aggressive things first,” says Dr. Robert Shmerling, Corresponding Faculty, Harvard Medical School.

However, if you choose to take a cortisone shot, know its limits. “The shots are almost always a temporary measure,” Dr. Shmerling says. “In general, it’s for symptom control, and not a definitive treatment for most conditions

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What Happens After A Lumbar Epidural Injection

The patient is returned to the recovery area where they are monitored by medical staff for 30-60 minutes. Prior to discharge, the patient is asked to record their levels of pain relief during the next week using a post-injection evaluation sheet .

A follow-up appointment will be made for a repeat injection pain block, if indicated.

Depending on the patients level of pain relief, another injection may be administered in 2 weeks. The patients back or legs may feel weak or numb for a few hours. This is to be expected, but it does not always happen.

How Do I Prepare For An Epidural

Your healthcare provider will give you specific instructions about what you need to do to prepare for your epidural. Be sure to follow their instructions. Your provider may:

• Have you not eat or drink for a certain amount of time before your epidural.
• Adjust certain medications youre taking, especially blood thinner medications.
• Make sure you have someone with you to drive you home after your epidural.

Questions that may be helpful to ask your healthcare provider before you get an epidural include:

• How often do you perform epidurals?
• What do I need to do to prepare for my epidural?
• What are the risks of getting an epidural?
• What will my epidural feel like?
• How long will my epidural last?
• How long will it take to recover from my epidural?

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How A Cervical Epidural Steroid Injection Provides Relief

Cervical epidural steroid injections are intended to treat pain provoked by conditions that cause inflammation to one or more cervical nerve roots. When a nerve root in the neck gets compressed or inflamed as it branches off the spinal cord and exits the spine, radicular pain can travel down the arm and into the hand. Cervical nerve root inflammation that leads to neurological deficits, such as numbness or weakness, is called cervical radiculopathy.

Read more about Cervical Radiculopathy Causes and Risk Factors

When performed by a qualified medical professional, a cervical epidural steroid injection directly places cortisone steroid medicine into the area of the spine that surrounds the inflamed nerve root. This medication may help reduce nerve root inflammation and relieve the associated pain, such as arm pain.

See How Epidural Steroid Injections Work

Can Getting An Epidural Cause Long

While its very rare, having an epidural procedure can lead to some long-term complications, including:

• Permanent neurologic deficit due to spinal cord or nerve root damage from the epidural injection.
• Chronic pain due to due to spinal cord or nerve root damage from the epidural injection.
• Permanent paralysis from a hematoma that occurs when theres a buildup of blood between the dura mater and the spinal cord.

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