Before settling on a surgical procedure to relieve debilitating back pain, your healthcare provider might explore various non-surgical options, including epidural injections. Dr. Garen Gajian asserts that epidural steroids injections (ESIs) can control spinal inflammation, inhibiting inflammatory responses, thanks to the direct injection on the pain’s source. Though the relief ESIs offer is temporary, the pain-free period allows you to move comfortably and do the activities you love. However, your physician might not recommend the steroids injections if you have a bleeding problem, are pregnant, or have an allergic reaction (to the solution).
How do epidural injections control inflammation?
Lower the production of inflammatory pain mediators. The steroids inhibit the production of proteins and other substances like leukotrienes and prostaglandins likely to mediate pain
Block the discs from releasing chemical substances. Herniated discs may release chemical substances likely to trigger nerve fibers, resulting in pain. Thus, the steroids might help synthesize particular inhibitors, preventing them from releasing the chemicals.
Reduce instant pain signals from the affected nerves. An irritated, compressed or inflamed nerve is likely to cause debilitating symptoms. Therefore, administering steroids on the pain-causing compressed nerve might help minimize the effects of the spontaneous pain signals.
Though the injections are effective in reducing pain, their effects are temporary. Therefore, your physician might suggest rehabilitation and therapy. Additionally, the medical professional might recommend possible future epidural injections to give you long-term results.
Type of steroids
The type of steroids your healthcare provider will administer during the treatment will depend on their dissolving ability, particle size, and aggregation ability. For instance:
- Non-particulate steroids
These water-soluble steroids have tiny easily-soluble particles that do not form lumps (aggregate together). However, they are short-termed. Thus, they will take a shorter period in your epidural space, offering short-term results.
- Particulate steroids
Unlike non-particulate steroids, these steroids’ particles are large. As a result, the large particles might lump together and stagnate at the treatment site for an extensive period, offering long-term effects.
When are epidural injections necessary?
Your doctor will most likely recommend the steroids injection to address leg and lower back pains resulting from spinal nerves. The pain that the medical expert might refer to as sciatica or radiculopathy happens when bone spurs or a herniated disc compresses a nerve root, mainly on your lower back, sending pain signals down your buttock, thigh and leg.
The medical professional might administer epidural injections to address sciatica resulting from conditions like:
- Disc degeneration (when the disc shrinks and reduces in height)
- Herniated disc (when the disc’s inner contents push through a crack and sip to the outer layers)
- Spondylolisthesis (when a spinal bone slips over the one beneath)
- Foraminal spinal stenosis (narrowing of the bony openings close to the nerve roots)
Besides the common sciatica causes, epidural steroids injections might also address nerve pain resulting from vertebral fractures or spinal cysts. Other indications that might benefit from the injections include annular tear and facet joint arthritis.
The steroids your healthcare provider administers on your epidural space have anti-inflammatory effects that inhibit pain signals from releasing chemicals likely to trigger pain. Thus, the injections help enhance your legs and lower back functions, allowing you to live a pain-free life for a while. Contact your doctor for help to prevent spinal inflammations from affecting your mobility.
