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Epidural Steroid Injections

Epidural steroid injections deliver powerful anti-inflammatory medication, or corticosteroids, at or near the source of nerve pain. The injection is administered directly into the epidural space that surrounds the spinal cord and nerve roots. Epidural steroid injections are generally considered a safe, minimally invasive treatment option that may provide pain relief to the lower back and legs. 

Epidural steroid injections have been used to relieve lower back and leg pain for decades, and they are even considered an important part of non-surgical pain management. Steroid injections are recommended by doctors if other nonsurgical treatments, like medication or physical therapy, prove to be ineffective. Epidural steroid injections are usually the last treatment option before surgery is considered. 

These injections are generally used for any condition that causes irritation and/or inflammation of the spinal nerve roots including:

  • Lumbar degenerative disc disease
  • Lumbar spinal stenosis
  • Lumbar herniated disk(s)
  • Sciatica

The goal of epidural steroid injections is to reduce inflammation in and around nerve roots. When pain is reduced, patients will experience improved mobility and function in their lower back and legs. Reducing pain and increasing movement and mobility is integral for recovery, as it allows for patients to begin physical therapy, or continue their physical therapy treatment. 

Benefits of Epidural Steroid Injections

The most noticeable benefit of epidural steroid injections is the almost immediate pain relief. 70-90% of patients experience pain relief lasting from one week to 1 year.

Epidural steroid injections work to reduce nerve pain and inflammation by decreasing the production of inflammatory chemicals and reducing the sensitivity of nerve fibers. The reduction of nerve fibers helps to generate fewer pain signals. 

Patients who undergo epidural steroid injections may also discover that their need for oral pain medication is limited. 

With decreased pain, patients will likely experience increased mobility, which is especially important for beginning or continuing physical therapy. In some cases, patients who can progress in physical therapy and recoup their movement may be able to postpone or eliminate the need for surgery altogether.

What Happens After an Epidural Steroid Injection

Following the procedure, patients may feel some discomfort where the injection was administered. Common, temporary side effects include post-injection pain, nausea, headache, dizziness, and fainting. These side effects should last only a few minutes or hours. Pain may remain the same or become worse 1-3 days post-procedure, as it usually takes 2-3 days for the steroids to begin working. 

In some cases, the injections are ineffective, and even if they are effective, patients experience only a short amount of pain relief. It is important for patients to let their medical team know if they do not feel pain relief, as it may be a signal that the pain does not originate from the spinal nerves.

If patients experience pain relief after their first injection, their doctor may consider a second injection when the effectiveness of the first injection begins to wear off. Patients may receive 3-6 epidural steroid injections over the course of a year.

Alternatives to epidural steroid injections

The Pain Institute of Middle Tennessee can help you find an alternative to epidural steroid injections for back and leg pain. We can work with patients to create a pain management plan that may include treatments such as nerve blocks, physical therapy, chiropractic care, and acupuncture. 

Are you or a loved one considering an epidural steroid injection? Request an appointment with one of our physicians today, and discover treatment options for your back and leg pain.