Sometimes cases of herniated disc back pain and other forms of pain associated with spinal problems will eventually heal; a little rest, physical therapy and over the counter pain medication is all you need.
But sometimes the back pain can be severe and debilitating. In those cases, epidural injections may provide temporary pain relief needed while the underlying condition is being treated with other therapies, or allowed to heal on its own. Steroidal epidural injections also provide the benefit of reducing inflammation, which contributes to herniated disc pain.
What is an Epidural Steroid Injection?
An epidural steroid injection delivers anti-inflammatory pain medication via a syringe for fast pain relief. As the name implies, the medication is injected into the epidural space around the spinal cord. The epidural space is filled with fat and small blood vessels, and surrounds the dural sac, which in turn surrounds the spinal cord, nerve roots and cerebrospinal fluid.
Typically the solution injected is a combination of a steroid, a local anesthetic, and saline. The steroid (cortisone) provides anti-inflammatory action. One of two different local anesthetics are commonly used: Lidocaine or Bupivacaine. Lidocaine is faster acting, but Bupivacaine provides longer term pain relief. The saline may be used in part to dilute the local anesthetic, and/or to flush out immunologic agents that are promoting inflammation.
How Long do the Effects Last?
The duration of the pain relief provided can vary widely from patient to patient, depending on your condition. Some experience pain relief for several days, while others experience extended relief for several months.
How Many Injections Can I Have?
It is common to receive a series of three injections, spaced about two weeks apart. However, some patients experience enough pain relief after the first injection that subsequent injections are not needed at that time.
In the event that the full three injections are received, you will have to wait six months to a year before you could receive another series of injections.
What are the Possible Side Effects?
Some patients may experience flushing, sweating and heart palpitations for a few days after the injection. There may also be a temporary increase of pain as the medication takes effect. Temporary weight gain and an increase in blood sugars may also be experienced.Rare side effects include accidental puncture of the dural sac, infection, and bleeding. In some cases no pain relief is experienced after the injection.