In general, pain is the body’s way of letting people know there is a deeper problem. However, there’s no reason we should continue to suffer from pain while working to address the deeper problems that pain points to.
Interventional pain management is a field of medicine specifically dedicated to helping provide comfort for patients who suffer from acute or chronic pain. While pain management specialists have many tools at their disposal, one of the common interventions they may suggest is an epidural steroid injection (ESI).
Read on for a full overview of ESIs and how they work.
What Is an Epidural Steroid Injection?
Epidural steroid injections have two main components: a corticosteroid and an anesthetic. There are many types of corticosteroids that may be used in an ESI, including prednisone, cortisone, hydrocortisone, and methylprednisolone. These medications work similarly to cortisol and can lower inflammation to relieve pain.
To perform an ESI, a pain management specialist will inject the medicine directly into the space surrounding your spinal cord (also called the epidural space). This can lower inflammation at the nerve roots and relieve pain.
ESIs are used to treat pain caused by many types of conditions, including the following:
- Herniated discs
- Spinal stenosis
- Sciatica
- Degenerative disc disease
- Osteoarthritis
- Nerve compression
- Post-surgical back pain
It’s important to note that ESIs do not cure the pain; it’s more like they simply quiet it for a while. Often, an ESI is used to relieve pain while a doctor works to treat the root cause.
How Do ESIs Work?
Corticosteroids are designed to mimic cortisol, one of the body’s natural anti-inflammatory hormones. These medications work by reducing the body’s production of chemicals that can cause inflammation.
Irritated nerves can become inflamed as your body tries to heal them. However, this inflammation can also cause pain and pressure on the nerves. By reducing this inflammation, corticosteroids can temporarily relieve pain. Meanwhile, the anesthetic part of an epidural steroid injection is there to relieve the pain immediately as the corticosteroid takes effect.
How Are ESIs Used in Pain Management?
There are three main types of epidural steroid injections. All of these injections use the same sets of ingredients, which means the main difference between them is simply the location of the injection.
These types of ESIs can include the following:
- Interlaminar Injections: These injections are administered between vertebrae and are common for widespread pain.
- Transforaminal Injections: These injections are administered close to where the nerve exits the spinal column and are helpful for pain that is isolated to a specific nerve.
- Caudal Injections: These injections are administered at the base of the spine near the sacrum and are mostly used for patients with lower back and leg pain.
ESIs are generally effective at relieving pain in about 50 percent of patients. The effects can last anywhere from a few weeks to a few months, after which you’ll need to get another injection to prolong the effects. Most healthcare providers recommend getting no more than four ESIs in a year.
While ESIs can relieve pain, they don’t cure the condition that’s causing your pain. Because of this, ESIs are often paired with interventions like physical therapy, chiropractic care, and acupuncture to help treat the root cause.
What To Expect From an ESI Appointment
First, it’s important to work with a pain relief specialist who understands the nature of your pain and has a track record of success. When looking for pain management in Tulsa, schedule a consultation to make sure the doctor is the right fit for you.
After you’ve found the right pain management provider, and if they recommend an epidural steroid injection, you’ll schedule your ESI appointment. Your doctor may ask that you stop taking certain medications, and they may also request that you fast for a few hours.
Bring a friend or family member to your appointment so that you have a ride home. Your provider will have you lie down as they use a needle to locate the best area to place the injection. The whole procedure should take 15 to 30 minutes.
Are There Any Side Effects of ESIs?
It is common to experience temporary discomfort at the injection site after an ESI, and you may also experience some mild headaches or dizziness. If you require any sedation, you may experience drowsiness as it wears off.
While rare, serious side effects can include infection, bleeding, or even nerve damage if the provider doesn’t place the injection properly. You may be able to avoid these side effects by choosing an excellent provider with a good reputation.
Who Should Consider an ESI?
You may be wondering if you would be a good candidate for an epidural steroid injection. If you think you could benefit from an ESI, the first thing to do is talk to your primary healthcare provider.
Your provider considers your healthcare history, the cause of your pain, and whether any other treatment options have worked. They’ll also consider the severity of your pain, how long it has lasted, and how it has affected your daily life.
If you currently have an infection, your doctor will likely wait to recommend an ESI until your infection has been treated. Corticosteroids can also increase blood sugar, which means you may not be a good candidate for an ESI if you have poorly controlled diabetes.
ESIs are generally not recommended during pregnancy since they can affect the baby. Finally, if you have a history of spinal instability, your doctor may recommend alternative treatment options.
The Bottom Line
Epidural steroid injections are common pain management interventions that can be used for everything from widespread back pain to specific nerve pain. There are a few different ways that ESIs can be administered, but they all work by lowering inflammation around the nerves. In interventional pain management, ESIs are usually used in conjunction with treatments like physical therapy.