Epidural shots for back pain
An epidural steroid injection uses the same type of cortisone as a regular cortisone injection. Cortisone is a type of steroid that is produced naturally by a gland in your body called the adrenal gland. Cortisone is released from the adrenal gland when your body is under stress. Natural cortisone is released into the blood stream and is relatively short-acting. Injectable cortisone is synthetically produced and has many different trade names (Celestone, Kenalog, etc.), but is a close derivative of your body's own product. The most significant differences are that synthetic cortisone is not injected into the blood stream, but into a particular area of inflammation. Also, the synthetic cortisone is designed to act more potently and for a longer period of time (days instead of minutes). An epidural injection places anti-inflammatory medicine into the epidural space to decrease inflammation of the nerve roots, hopefully reducing the pain in the back or legs. The epidural injection may help the injury to heal by reducing inflammation. It may provide permanent relief or provide a period of pain relief for several months while the injury/cause of pain is healing. To administer the epidural steroid injection, your doctor will have you either sit up or lie flat, face down. The skin on the back is scrubbed using 2 types of sterile scrub (soap). Next, the physician numbs a small area of skin with numbing medicine. This medicine stings for several seconds. After the numbing medicine has been given time to be effective, the physician will start the procedure. Using special landmarks a needle will be advanced to an area very near to the spinal nerves, called the epidural space. The epidural steroid injection procedure takes about 15 minutes, and light sedation may be used if needed. Epidural steroid injections may be given by many types of physicians, including anesthesiologists, rheumatologists, orthopedic surgeons, neurologists, interventional radiologists, and others trained in this technique. Usually a series of injections, often three, each spaced a week apart, are given. With this schedule, many patients find relief of symptoms within a few weeks. Often this helps control the inflammatory process and may provide long-lasting relief. Side-effects from epidural steroid injections are rare, but should be discussed. These include: • Infection: Very unusual (less that 0.5%), and usually avoided by using a sterile technique. Epidural steroid injections should be administered using either ultrasound or fluoroscopy for guidance of the needle.
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