The Vault

As early as 1952, epidural steroid injections (ESIs) are considered one of the most common treatments for low back and leg pain. Until now, it is still one of the important non-surgical approaches for sciatica and other forms of low back pain. The injection aims to temporarily relieve pain and is commonly combined with other rehabilitation programs in order to maximize its benefits. Even if its effect is temporary, ranging from one week to one year, it can still provide enough pain relief to enable the patient to perform rehabilitative stretching and other exercise programs.

Aside from treating the low back or lumbar region, epidural steroid injections can also be used to relieve pain in the neck or cervical region as well as the mid spine or thoracic region. Further studies are required in order to document the long-term role of ESIs in sciatica and low back pain, which have become topic of continued scholarly debate. Despite lack of sufficient proof for long-term relief, reports showed that more than 50% of patients experienced measurable pain relief after being injected.

Benefits of ESIs

In epidural steroid injection, the patient is injected directly or very near the source of pain. This is unlike oral steroids or painkillers that tend to disperse, resulting to a less-focused impact that could bring side effects. Epidural steroid injections can also help control local inflammation, which causes the pain. It also flushes out any inflammatory proteins and chemicals that contribute to the pain.

Patients with certain conditions should be careful when it comes to this procedure:

  • Patients with local or systemic infection
  • Pregnant patients since fluoroscopy (an X-ray type) will be used
  • Patients with bleeding problems and those who are taking blood thinners such as Coumadin
  • Patients that have spinal tumor. An MRI should be performed prior injection to rule out the possibility
  • Patients with allergic reaction to the injected solution
  • Patients with uncontrolled medical problems. This includes renal disease, congestive heart failure and diabetes
  • Patients that are taking high dosages of aspirin or other anti-platelet drugs

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