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The Use of Epidural Steroid Injections for Pain Management

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An epidural steroid injection is a surgical procedure that involves surrounding an inflamed spinal nerve with a steroid, which is a strong anti-inflammatory drug. The primary benefit of this procedure is to reduce irritation in the nerve, thereby relieving the patient's pain. Physicians often use an ESI to relieve the pain caused by an abnormal narrowing of the spinal canal, known medically as spinal stenosis.

Procedure

A radiologist typically performs imaging tests such as a computed tomography scan or magnetic resonance imaging to identify the spinal nerves that are being squeezed. An ESI generally contains a combination of a local anesthetic such as lidocaine and a corticosteroid. The physician inserts a camera into the spinal canal and administers the ESI into the epidural space that lies outside the membrane, or dura, that surrounds the spinal cord.

Benefits

A physician typically performs an ESI only after nonsurgical treatments have been ineffective in relieving the patient's pain. The local anesthetic in an ESI can provide short-term pain relief due to an inflamed spinal nerve, although it won't relieve inflammation. The corticosteroid provides long-term pain relief by reducing inflammation and swelling of the spinal nerve, but this requires more time to take effect than the local anesthetic.

Effectiveness

An ESI typically relieves pain for two to three weeks, although researchers have not yet studied its long-term effectiveness. It's most effective in relieving leg pain due to a spinal stenosis in the lumbar region, or lower back. Some patients are able to obtain sufficient pain relief from an ESI that they can forgo or delay spinal surgery, although this procedure won't cure spinal stenosis.

Side Effects

The most common side effect of an ESI is tenderness at the injection site that lasts no more than four days, and other side effects include dizziness, headache and nausea. Most doctors recommend that a patient receive no more than three ESIs in a 12-month period, with at least two months between ESIs. Each area usually should receive a total of no more than four injections.

To see if you are a candidate for pain managemnet with the use of an Epidural Steroid Injection, schedule an appointment with our pain management clinic in Orange County.