Epidural Injections. Understand Your Options
An epidural steroid injection is classified as a minimally invasive procedure that can help relieve neck, arm, back, and leg pain caused by inflamed spinal nerves. The injection is directly delivered to the spine.
The additional fluid is used to flush out the mediators from the source of pain. Steroids work by reducing the activity of the immune system to react to inflammation associated with nerve or tissue damage. The primary immune response of the body is to produce white blood cells in order to protect it against bacteria or viruses.
Typically, a solution containing cortisone with local anesthetic or saline is used.
A steroid is usually injected as an anti-inflammatory agent which helps to reduce pain. Triamcinolone acetonide, Dexamethasone, and Methylprednisolone acetate are commonly used steroids.
Lidocaine is a fast-acting local anesthetic used for temporary pain relief. Bupivacaine, a longer lasting medication, may also be used. These anesthetics are used to dilute the chemical or agents that produce inflammation. Saline is used for diluting the local anesthetic or as a flushing agent to dilute the chemical or immunologic agents that promote inflammation.
There are four main types of epidural injections:
- Cervical epidural steroid injection procedures
These are injections that relieve pain in the neck, shoulders, and arms caused by a pinched nerve or inflamed nerve in the cervical spine. Conditions including herniated discs, spinal stenosis or arthritis, can compress and pinch nerves, causing inflammation and pain.
- Thoracic epidural steroid injection
This is a thoracic pain treatment applied to relieve pain in the mid-back and shoulder blade area caused by a pinched or inflamed nerve in the thoracic spine. Conditions including herniated discs, arthritis or spinal stenosis can compress nerves causing inflammation and pain.
- Lumbar epidural steroid injection
This may be used to reduce the inflammation around the spinal nerves. Many spinal conditions, including a lumbar herniated disc, can cause inflammation or pressure on the nerve roots leading out of the spine, resulting in pain, tingling, or numbness along those nerves.
- Caudal steroid injection
This can help reduce lower back and leg pain caused by sciatica, herniated discs, bone spurs or other back problems. Some nerves run from your spinal cord out to your back and legs. A caudal injection is injected into the lowest portion of the epidural space.