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Placed directly into the sac around nerve roots (dura), epidural injections are the most common type of injection used for pain relief purposes.
- Epidurals typically provide relief that’s more immediate than what’s usually provided with oral medications.
- It’s a pain management technique that can supplement existing treatments and ease inflammation.
Before Epidural Injections Are Given
MRIs, CT scans and similar image tests are often performed prior to administering injections to determine the exact location of the affected nerve root. Such tests may also be done to rule out other potential sources of back or neck pain that may not be treatable with an epidural injection, such as damage to the spinal cord itself.
How Injections Are Administered
During the procedure, patients are placed in a comfortable position on a table on their stomach. A special type of x-ray (fluoroscopy) is used as the injection is given in order to help the doctor place the needle in the correct location. Including the brief recovery period where patients are observed following the injection, the entire procedure can usually be completed in less than an hour.
Reasons for Epidural Injections
Injections are usually recommended for one of two reasons: therapeutic or diagnostic purposes. When used for therapeutic purposes, additional medication is usually included with the shot to ease nerve irritation. For diagnostic purposes, epidural injections may be inserted into isolated nerves to determine whether or not that nerve is a source of local or radiating pain. A common example of this is when sciatic nerve is a suspected cause of discomfort extending to lower extremities.
When to Consider Injections
Epidural injections may be recommended for back pain that’s related to conditions that aggravate nerves. This includes persistent discomfort due to disc herniation, degenerative disc disease (DDD), and narrow spinal spaces (spinal stenosis). Injections may also be beneficial if pain makes it difficult to perform muscle strengthening and conditioning exercises and other forms of physical therapy.
Relief experienced from the injections may be immediate due to the numbing effects of the local anesthetic included with the shot. It may take a week to enjoy prolonged benefits from the steroid medication. Over time, the reduction in swelling may allow nerve roots to heal, further providing pain relief for patients.
Who Can Receive Epidural Injections?
Risks associated with epidural injections are minimal. Suitable candidates for the procedure are individuals who have chronic pain that’s not responding well to other treatments. Injections aren’t recommended for patients who have spine pain related to tumors or infections.
Epidural injections are effective for about half of all patients who receive them. Relief may last anywhere from several weeks to a year or more. The results experienced will depend on whether or not there are other factors contributing to spine-related pain and a patient’s overall health. There is no conclusive research into how frequently injections should be given, although the standard recommendation is no more than three times a year.