Epidural Steroid Injection for Back Pain
An epidural steroid injection is commonly used to treat unremitting spinal nerve root irritation (e.g., a “pinched” nerve in the neck or low back). Spinal nerve root irritation most frequently occurs either in the cervical or lumbar spine and is due to compression of the nerve root by a protruding or herniated disc.
Cervical and lumbar disc disease affects millions of Americans each year. Conservative treatment consists of oral nonsteroidal anti-inflammatory drugs (e.g., ibuprofen), stronger painkillers such as opioids and often, physical therapy. When this regimen fails to relieve pain, epidural corticosteroid injections are frequently the next chosen step.
Anatomy of the Spinal Cord
The spinal cord is suspended in cerebrospinal fluid and encased in three membranes. The outermost membrane is the toughest and is called the dura. Each spinal nerve exits the membrane-enclosed sac just below its corresponding vertebra. Thus, an “epi”-dural injection bathes the spinal nerve after it exits the outermost membrane.
Epidural Injection Procedure
The injection is performed with the aid of fluoroscopy which is a real-time x-ray technique that allows the physician to visualize the placement of the needle. The injection is localized to the spinal level that is clinically suspected to be involved.
Injection of the corticosteroid medication in this way allows the use of a high dose for maximal anti-inflammatory action directed to the affected nerve root. The rest of the body is spared exposure to such a high dose.
Limitations of Epidural Injections
Epidural steroid injections are typically limited to a series of three. Deleterious effects of the hormone on the spinal tissues are thus minimized.
If you suffer from back pain you may be a candidate for an epidural injection. Contact one of NYC’s most experienced pain doctors, Dr. Matthew Grimm, for more information about epidural injections.