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Epidurals

Epidural Injections

Epidural steroid injections are a common, effective treatment option for patients with a variety of back, neck or radicular pain. These injections reduce inflammation in and around nerve roots to relieve pain, give your body space to heal and improve mobility and functionality.

Most epidural pain management injections combine a steroid with an anesthetic like lidocaine to provide immediate pain relief and longer-term inflammation control. These two medications are injected into the epidural space of your spinal canal between the bones and the area with spinal fluid.

Epidural back pain relief injections are often used after less aggressive treatments and over-the-counter medications have failed to provide the pain management you need. These injections are considered minimally invasive and relatively safe, with few temporary side effects.

How Do Steroid Epidural Injection Procedures Work?

When you get an epidural steroid injection, the steroid and anesthetic are applied as closely as possible to the source of your pain. The medications work to surround your irritated nerve roots to reduce swelling, inflammation and pain.

Your injection may also help to cleanse the area experiencing pain by removing inflammatory proteins that could be increasing the severity of your symptoms. With these proteins and other inflammation cleared away, your body has the opportunity to begin healing itself more effectively.

The relief your epidural injection offers can also provide you with a greater range of motion and mobility. This reprieve may allow you to more successfully take on other treatment options like physical therapy and rehabilitation for long-term alleviation of your discomfort.

At the Spine Institute of North America, we offer several types of epidural injections to help manage different kinds of pain. We’ll inject your medication in targeted areas of your spine so that it has the best access to the nerves causing the issue.

Cervical Interlaminar Epidurals

Cervical interlaminar epidural injections are a great option for patients with neck pain, herniated or bulging cervical disks, or radicular pain in their shoulders, neck and arms.

With this type of epidural treatment, your doctor will administer your injection at the top of your spine between the cervical vertebrae. The medications quickly treat the nerves of the cervical spine and begin to relieve inflammation and pain in your upper extremities.

Patients who receive cervical interlaminar epidurals can experience a significant and immediate reduction in their level of pain. Some may even find that their pain is entirely gone after only one treatment. If you find some relief, you can schedule additional injections to help you experience the treatment’s full effects.

Caudal Epidural Steroid Injections

Unlike cervical epidurals, caudal epidural injections are administered through an opening in the sacrum at the base of the spine just above the tailbone. This lowest segment of your spinal column contains nerves that extend through your legs and feet. When one of these nerves is inflamed, the pain can travel through your lower back and legs.

Caudal epidural steroid treatments are intended to relieve inflammation and pain associated with lower back nerves, including sciatica, pain in the buttocks and thighs, disc disease and spinal stenosis. Injections can be repeated periodically for continued relief.

Lumbar Interlaminar Epidurals

Patients with chronic lower back and radiating leg pain could be candidates for pain management through lumbar interlaminar steroid epidurals. While caudal epidurals also treat lower back and leg pain, lumbar interlaminar injections are delivered more directly to the source of your pain, often in the central space between your L4 and L5 vertebrae.

Lumbar interlaminar epidural injections provide significant relief for most patients after one or two injections. This treatment can be repeated up to four times per year for longer-term pain management.

Lumbar Transforaminal Epidurals

Lumbar transforaminal epidurals treat those suffering from a variety of lower back pain, including pain caused by annular tears, scoliosis, herniated disks, neuropathic pain and sciatica. During this treatment, your doctor will administer your injection into your epidural space by way of the foramina, the spaces between vertebrae along the sides of your spine.

Administering the lumbar transforaminal epidural injection into the foraminal space allows it to most effectively target irritated nerve roots to reduce pain and inflammation. This treatment may provide significant pain relief. If the pain returns within a year or two, you may be a good candidate for other minimally invasive procedures.

What do we do?

Providing a thorough diagnosis to know the cause of your pain

Using the least invasive procedure that will relieve your pain quickly

Providing effective follow-up to ensure fast recovery

Ensuring that you remain fit so that you can enjoy long-term relief from pain

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What to Expect After an Epidural Steroid Injection for Back Pain

All four epidural injection procedures are quick and relatively painless. Most patients characterize the injection pain as no worse than a routine blood draw. Your doctor will have you lay on your stomach and will apply a local anesthetic to your injection site to numb the external tissues and the tissue surrounding your spine.

Your doctor will then insert a needle into the desired location using a real-time X-ray machine called a fluoroscope and contrast dye to ensure the medication will be administered on the correct path. Next, they inject the steroid and anesthetic medication, and it begins to bathe the irritated nerve roots and inflamed tissues.

Directly following your procedure, a medical professional will watch you for about 15 minutes to ensure you recover well. You should have someone drive you home, as you may experience some temporary numbness in your legs. Most of the side effects you may experience from the procedure are minor and short-lived, wearing off within a few hours. These side effects could include:

  • Low-grade fever.
  • Headache.
  • Fluid retention.
  • Insomnia.
  • Soreness at the injection site.

Your doctor will direct you to take it easy for the rest of the day following your procedure and gradually work up to your normal activity level over the next several days.

How Long Does Epidural Pain Relief Last?

You’ll likely feel immediate pain relief following your epidural injection because the anesthetic begins working to reduce pain right away. This effect could last for a few hours before it begins to wear off, and some pain may return. You should begin to feel the effects of the steroids a couple of days after the procedure.

How long your pain relief will last varies greatly from patient to patient. Some achieve only short-term partial relief, while others experience total alleviation for several months. Most epidural steroid injections should provide some pain management for about three to six months. Lumbar transforaminal epidurals typically provide relief for as long as one to two years.

Is a Nerve Block the Same As an Epidural?

Nerve block treatments are similar to transforaminal epidural injections, but the steroid and anesthetic medications are injected directly into the nerve root where it exits along the spinal column instead of being injected into the epidural space. These injections block the pain sensation from the targeted nerve and help to reduce inflammation.

How Long Does an Epidural Nerve Block Last?

Nerve block injections only remain effective for approximately four hours. These treatments are meant to block the pain sensation from the targeted nerve for a specific purpose, like identifying the source of pain to better establish a treatment plan.

Find Out If You’re a Candidate for Epidural Injections

At Spine Institute of North America, we’re dedicated to helping you treat and eliminate your back pain so you can lead a more comfortable life. Take our pain evaluation questionnaire to determine if you may be a good candidate for epidural injections, or get in touch with our team to schedule a free consultation.

Our team of specialists has extensive training in minimally invasive procedures and options for addressing the sources of back pain. We’d love to discuss your concerns and symptoms so that we can formulate a treatment plan that will address your specific needs and provide you with some much-needed relief.

Give us a call at 609-371-9100 or fill out our online contact form to get started!

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