The cervical spine is the top seven vertebrae of your spine. The thoracic area of the spine has twelve vertebra. The lumbar portion of the spine has five vertebrae. When your pain involves irritation of the nerves of the spine, our doctors may recommend an Epidural Steroid Injection. Soft discs found between the vertebrae cushion them, hold them together, and control motion. If a disc tears, chemicals inside may leak out. This can inflame the nerve roots and cause pain. A large disc tear may cause a disc to bulge, inflaming the dura and nerve roots, and cause pain. Bone spurs, called osteophytes, can also press against nerve roots and cause pain.
In a Steroid Epidural Treatment a local anesthetic (numbing medicine) and a corticosteroid (anti-inflammatory medicine) are placed in the epidural space to reduce inflammation. It may be done from the back. This is called an Interlaminer Injection. Other times it is done from the side. This is called a Transforaminal Injection. If the instrument is positioned next to an individual nerve root, it is called a Selective Nerve Root Block.
A local anesthetic may be used to numb your skin. Our doctor will then insert a thin tool into the epidural space. Fluoroscopy, a type of x-ray, is used to ensure the safe and proper position of the instrument. A dye will be used to determine that this is the correct spot. Once the instrument is correctly placed, an anesthetic and steroid will be used.
You will be monitored for up to 30 minutes after the treatment. When you are ready to leave, the clinic will give you discharge instructions. You will also be given a pain diary. It is important to fill this out because it helps your doctor know how the treatment is working. It may help to move your back in ways that hurt before the treatment to see if the pain is still there, but do not overdo it. Take it easy for the rest of the day. You may feel immediate pain relief and numbness for up to six hours after this treatment. This tells you that the medication has reached the right spot.
Your pain may return after this short pain-free period, or may even be a little worse for a day or two. This is normal as this treatment can cause some irritation. Steroids usually take two or three days to start working, but can take as long as a week. You can usually return to work the day after your treatment, but always check with your doctor.
Sometimes epidural steroid treatments bring several months of pain relief and then further treatment is needed. Other times, a single treatment brings long-term relief. If your pain is caused by injury to more than one area, only some of your symptoms will be helped by a single treatment.
The amount and duration of pain relief varies from person to person and is dependent on many factors including underlying pathology and activity level. Some persons can have relief that lasts for years, while others have short-term relief. Usually a series of treatments, often three, each spaced several weeks apart, are given. It is important to discuss your response to epidural steroid treatments with your physician in order to plan future treatment options.