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What is an Epidural Steroid Injection?

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  • Written By: O. Wallace
  • Edited By: Bronwyn Harris
  • Last Modified Date: 18 September 2016
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For anyone who has suffered from lower back pain or sciatica, they can attest that it can be extremely debilitating. Relief from the pain is necessary to function normally, and many lower back pain sufferers find it in the form of an epidural steroid injection. Many people automatically associate an epidural with the pain medication administered to women in labor. In reality, the only thing that they have in common is that a pain medication and steroid is administered into the epidural space in the spine.

An epidural steroid injection is utilized primarily for pain relief for people suffering with lumbar 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 the inflammation caused by slipped, herniated or bulging disks. Sciatica, which manifests itself as sharp, shooting pains in the lower back, and legs, is also due to inflammation pressing on nerves in the back.

Epidural steroid injection has been utilized since the middle of the 20th century as a non surgical option for pain relief. Although it is typically temporary relief — 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 exercises to strengthen the back.

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The benefit of the epidural steroid injection is that it is a localized pain treatment method, which targets the specific location of inflammation. The injection typically contains a steroid, such as cortisone, methylprednisdone or dexamethasone, which calms the inflammation. A local anesthetic such as lidocaine is also injected for temporary pain relief. Occasionally, saline solution will be added to dilute the medications as well as to flush the 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 anesthesiologist can give you an epidural steroid injection as a first step in treating back pain. Depending on the severity of the pain and inflammation, you may get a round of three shots initially. The epidural steroid injection is successful in treating pain about half the time, while others may experience no relief, or a slight impact on their pain.

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anon358448
Post 5

I had my first epidural today. My doc also didn't use x-rays. He had me pull my pants down a little, and while standing up. pushed on my back about four times and put the needle in. Now I am in more pain than I started with. It has been only 14 hours. Does anyone know if this is normal?

anon311189
Post 4

When I had my first injection in my L4 and L5 the pain became worse. The insisted on doing another injection and I lost consciousness when I had the second one. Then they asked me for the third time, and I said no way. My condition was way past the point when shots would work, but they had to go through the motions.

I ended up with permanent nerve damage after a fusion of the lower back.

From what I see. anyone with a really bad back with pain and does manual labor has very low success rate with shots. It hides the pain and can get really ugly. Be very careful and sadly, doctors will side with companies in opinion to keep their lifestyle going.

anon307860
Post 3

I have had a lumbar epidural and I stopped breathing and had burning in my leg and couldn't put any weight on it. Now I have right leg pain and three bulging discs.

anon47728
Post 2

Never heard of a doctor giving an epi without use of an guided x-ray. Sounds kind of careless to me. I would find another doctor. The doctor needs to get it into the right spot in order for you to get relief so "guessing" just doesn't do it. Move on.

karfully
Post 1

Had the epidural today. No result. Also didn't have the aching I was told I would have after the lidocain wore off (which never affected me). Could he have missed the space surrounding my spine (dural?)? If he did and it went elsewhere, is that dangerous to me? He did not use xray....it was a blind injection. Should I request a different group of doctors? Karen

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