Epidural Spinal Injection Specialist In California | Expert Care for Nerve and back Pain relief
Andrew H. Messiha, MD, Double Board Certified in Anesthesiology and Pain Medicine, Laguna Hills, CA / Epidural Steroid Injections
Advanced pain management techniques may be recommended for severe chronic pain.
What is the Epidural Steroid injection?
An Epidural Steroid Injection (ESI) commonly known as spinal injection for back pain, it is a non-surgical pain management treatment in which inflammatory medication (corticosteroid), combined with a local anesthetic is precisely injected into the epidural space of the spine the main goal of an epidural steroid injection is to reduce inflammation and pressure on irritated spinal nerves, which helps alleviate pain and commonly used to manage severe pain caused by spinal stenosis, degenerative disc disease, sciatica , herniated discs and radiculopathy when this non-surgical treatment does not provide relief then specialist might be recommended surgical intervention.
How does an epidural spinal injection work?
An Epidural Steroid Injection (ESI) works by injecting a combined medication of corticosteroid and local anesthetic safely into the epidural space around the spinal nerves to reduce inflammation, pressure, and pain. The corticosteroid medication blocks these inflammatory chemicals, which reduces nerve irritation and swelling, and the local anesthetic temporarily blocks the pain signals that travel from nerves to brain, and you get fast relief from chronic pain. These help to restore normal function and decrease pain gradually through healing.
What is an epidural injection made of?
Epidural injections are administered into the epidural space of the spine. The epidural space location is between the outermost covering of the spinal cord (dura mater) and the wall of the spinal canal, and it contains fat, small blood vessels, and spinal nerve roots.
An epidural spinal injection is made of two main medications: such as a corticosteroid and a local anesthetic.
Corticosteroid (steroid):
It is an anti-inflammatory drug that reduces swelling, inflammation, and irritation around the inflamed spinal nerves.
Local Anesthetic:
A medication that temporarily numbs a small, specific area of the body by blocking nerve signal transmission to prevent pain
Indications for Epidural Steroid Injection
Epidural steroid injections are commonly recommended for managing pain caused by irritation or compression of spinal nerves. And this injection is specifically used in conditions such as spinal stenosis, herniated disc, arthritis and sciatica, and degenerative disc where inflammation plays a vital role in pain.
This injection may serve two important clinical roles:
Diagnostic Use: Medication is injected to determine the exact spinal nerve responsible for the patient’s pain when symptoms are undetermined.
Therapeutic Use:The injection is used to reduce inflammation and provides short- or long-term pain relief. It helps patients to improve mobility and resume daily activities.
Doctors suggest that epidural spinal injection is not a permanent cure for spinal disorders; instead, it is a supportive treatment to control pain, decrease inflammation, and improve the effectiveness of rehabilitation programs such as physical therapy.
Procedure of Epidural Steroid Injection
Epidural spinal injection is usually performed as an outpatient procedure in which the patient can go home the same day.
Firstly, trained medical staff take the patient to the pre-procedure area where medical history reviews, vital sign checks, and current medication confirmations are done; blood sugar and blood clotting status may also be checked if required.
Next, the patient will be taken to the procedure room and lie his face down on a table to comfortably proceed with the procedure.
Then the injection site is cleaned, and a local numbing medicine is given so the patient does not feel pain during the procedure.
A thin, hollow injection needle is guided into the epidural space using live X-ray (fluoroscopy). This helps the doctor to see the exact needle position on a screen for safe procedure.
A contrast dye is then injected through the safely placed hollow needle to confirm that the medication reaches the affected nervous system.
Once the doctor confirms the correct needle position, the anesthetic and corticosteroid are injected into the spine through the same needle.
Finally, the needle is removed, and the injection area is covered with a clean, sterile bandage.
What to Expect after an Epidural Steroid Injection
The patient may feel some pressure during the injection, but the procedure is generally painless. It takes about 15-30 minutes to complete. Afterward, follow doctor’s guidance, such as avoiding driving or returning to work. Strenuous activities should be avoided for a short period. The doctor may provide specific post-procedure instructions. Patients have to follow them, which helps in fast recovery.
Epidural Spinal Injection: Recovery and Pain Relief Timeline
After the procedure, patients may feel numbness in the arms or legs. This is usually due to the anesthetic and typically resolves within 1-8 hours. And some back pain may continue, as the steroid medication can take 24-72 hours to provide relief. If pain does not recover so the doctor may recommend a repeat injection. But doctors generally advise no more than 3 three epidural spinal injections in a year to avoid side -effects. surgery may be considered as a last option if injection does not work.
What are the pros and cons of spinal injections?
Pros (Benefits):
- Effective pain relief: Epidural spinal injections help reduce pain caused by herniated discs, spinal stenosis, sciatica and radiculopathy.
- Non-Surgical Treatment: It is an alternative option of surgery.
- Quick procedure: it performed on an outpatient basis means allowing patients to return home on the same day.
- Reduces Inflammation: The corticosteroid medication helps reduce swelling around irritated nerves and improves movement.
Cons (Risks / Complications):
- Injection site problems: bleeding, infection or pain may occur at the injection site.
- Nerve-Related Complications: Post-injection headache, temporary numbness or nerve damage may happen.
- Systemic Risks: it is uncommon but serious complications such as bladder dysfunction, respiratory issues, epidural hematoma, fluid retention, or spinal cord infarction.
- Temporary relief: sometimes multiple injections are required to provide pain relief.
- Procedure Limitations: doctors usually do not prefer more than 3 epidural injections per year due to risk and complication.
How long will a spinal epidural last ?
It depends on the patient’s condition. A spinal epidural steroid injection can provide pain relief that lasts from a few days to several weeks or can be several months. In many cases, it has been seen that the improvement can even last up to a year or longer. The duration of relief depends on factors such as the cause and severity of the nerve inflammation. Because steroids carry potential risks and side effects, healthcare providers do not recommend more than three epidural steroid injections in a year to reduce side effects or risk.
Who is a good candidate for epidural spinal injection?
Those people who are suffering from radiating pain( sciatica/radiculopathy) condition caused by herniated discs, spinal stenosis and who did not get relief from conservative treatments.
Who administers an epidural injection?
It is administered by a qualified medical specialist, mostly a pain management specialist, spine specialist or anesthesiologist. the procedure requires expertise to safely and accurately place the injection.
FAQ
1. What not to take before an epidural injection?
Do not take anti-inflammatory medication before an epidural injection unless your doctor allow it.
2. Who can insert an epidural?
A healthcare provider such as an anesthesiologist or pain management specialist.
3. Does an epidural help you sleep?
Not directly, but by reducing pain, it helps you relax, due to which you may be allowed to sleep more comfortably.
4. Is epidural injection safe during pregnancy?
Yes, epidural injections are generally considered safe during pregnancy, but it carries small risks such as blood pressure, headache, infection, should be performed under a doctor’s guidance.