Epidural steroid injections (or corticosteroid injections) are pain relievers. They work directly, delivering steroids into the spine via injection. A saline solution flushes out inflammatory mediators. However, these can also be an additional source of pain.
The injection goes into the epidural space. This covers the dural sac in the spine, which houses fat and small blood vessels. The dural sac surrounds your spinal cord. Plus, it also covers the cerebrospinal fluid that surrounds your nerve roots.
The solution is a combination of using the steroid, a local anesthetic, and saline. The typical steroid for this is cortisone and the anesthetic is lidocaine.
The steroid injection is an anti-inflammatory compound. When lower back pain appears, inflammation is often a factor. Therefore, reducing the inflammation will also reduce pain. The most common steroids used are as follows:
- Triamcinolone acetonide
Lidocaine acts immediately to reduce pain temporarily. Bupivacaine is another pain reducer, however, it lasts longer. These anesthetics flush out compounds that cause inflammation. Therefore, relieving some pain is a secondary property.
Saline is for dilution of the anesthetic and for flushing out inflammatory agents.
Please also see, “Are Cortisone Injections Bad for You?”
Using Epidural Steroid Injections to Control Inflammation
Sciatica, or radicular pain, is one of the most common types of pain. It originates in your lower back from a pinched nerve. Pain radiates down the leg and into the foot. And corticosteroid injections are used to treat sciatic pain.
Inflammatory chemicals such as IL-1, prostaglandin E2, and substance P causes pain. These are commonly found in lower back issues like disc herniation and arthritis. These conditions cause inflammation which irritates the nerve root. The result is sciatic pain.
Steroids have been found to inhibit the actions of these inflammatory agents. They reduce the activity in your immune system. Because of this, however, it does not react to inflammation from nerve damage. Normally, your immune system would send white blood cells. They are designed to protect you from infection. But, the inhibition by steroids prevents this. Therefore, inflammation and pain in the area are reduced.
When Do You Need a Corticosteroid Injection?
There are a number of conditions that can cause severe enough pain for this procedure. However, chronic low back pain and sciatica are the most common. Additionally, you can seek treatment with corticosteroid injections for the following:
- Lumbar disc herniation. The nucleus of the disc pushes through and into the spinal canal. Therefore, it increases pressure in the spinal column and on the nerves.
- Degenerative disc disease happens when a space between the disc collapses. As a result, nerves in the lower back become impinged.
- Lumbar spinal stenosis. The spinal canal narrows, cutting off nerves. This condition causes significant pain.
- Compression fractures in the vertebra
- Annular tear. This occurs when a tear is present along with the outer layer of the disc.
- Cysts. These develop at the facet joint in the spine. The nerve roots are compressed and cause pain. Cysts can expand to cause increasingly worse pain.
Many people with lower back pain find relief in spinal steroid injections. Furthermore, they reduce pain in the back and associated pain in the legs. For the best results though, a combination with injections and a therapeutic exercise program is best.
If you are searching for pain relief, call us at 888-409-8006.