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An epidural injection is a form of interventional pain management. The doctor injects a corticosteroid and a local anesthetic into the epidural space of the spinal canal, near the spinal nerves, to treat inflammation that causes pain in the neck, back, arms, or legs and reduce that pain.
An epidural injection is often a good procedure to treat conditions like spinal stenosis (narrowing of the spinal canal), herniated discs, sciatica, and spondylolysis.
At Silver Spine & Neurological Center in Sherman, Greenville, and Mckinney, Texas, Dr. M. Viktor Silver, MD, FACS, FRCS and Manaf Younis, MD, MPH, administer epidural injections to our patients who need pain relief from a variety of spinal conditions. Here’s our expert’s take on when you should consider an epidural injection for back or neck pain.
Back and neck pain are extremely common and can result from a variety of injuries and conditions. Most often, the cause is an injury to the muscles or tendons in your back that support the spine.
The most common areas for pain include the cervical (neck) spine, or C-spine, and the lumbar (lower back) spine, or L-spine, as these are the parts of the spine that move the most and generate wear-and-tear damage.
Almost everyone develops lower back pain at some point in their lives, ranging from mild to severe. For most, it’s a temporary condition. But long-lasting (chronic) lower back pain is common as well, found in up to 23% of adults globally. In extreme cases, the pain can interfere with walking, sleeping, working, or doing everyday activities.
Spondylolysis is the medical term for a small fracture that occurs between the tiny ridges of bone (the pars interarticularis) that join two vertebrae in your spine column, which is made up of 33 bones total. The pain, which is the primary symptom, often feels like a pulled muscle.
If you don’t treat spondylolysis, it can lead to a more damaging condition called spondylolisthesis. If your vertebrae are cracked or weakened enough by spondylolysis to slip out of place and press on a nerve in the spinal canal, you may develop pain that shoots into your legs (sciatica).
While spondylolysis is usually treated conservatively, some people need surgery to relieve the symptoms of spondylolisthesis and get back to their normal routine.
Spinal stenosis happens when the space inside the spinal canal is too small for the nerves to run through it normally. The restricted space can put pressure on the spinal cord and nerves that travel through the canal, causing pain, weakness, numbness, and tingling along the path of the nerve.
Some people, though, have no symptoms.
The most common cause of spinal stenosis is the general wear-and-tear damage that occurs in the spine due to age-related osteoarthritis. People with serious spinal stenosis may need surgery, which can create more space inside the spine, easing the symptoms. But since no surgery can cure arthritis, arthritis pain in the spine may continue.
Some people are born with a narrow spinal canal, but most stenosis occurs when something reduces the amount of open space within the spine. Causes include:
Wear-and-tear damage can cause extra bone tissue to grow on the vertebrae. If this tissue pushes into the spinal canal, it can impinge on nerves and nerve roots.
Intervertebral discs act as shock absorbers between vertebrae. If the material covering the discs cracks, causing the inner material to spill out, it can press on the spinal cord or nerves.
The strong bands of tissue that help hold the bones of the spine together can stiffen and thicken over time and push into the spinal canal.
Car accidents, falls, and other trauma can cause spinal bones to fracture or move out of place. In addition, swelling of nearby tissue immediately following back surgery also can impinge upon the spinal cord or nerves.
An epidural steroid injection (ESI) is an injection of anti-inflammatory medicine — a steroid or corticosteroid — into the epidural space around the spinal nerves in your neck or back, depending on where the problem is. The main goal of these injections is to manage chronic pain caused by irritation and inflammation of the spinal nerve roots.
EPIs are among the most common types of therapy for managing pain that radiates from the spine into the arms or down the legs. EPIs most often lead to pain relief that lasts about three or four months.
If you’re dealing with traveling pain from spinal compression, an epidural injection into your lower back or neck may make all the difference. To set up a consultation with Dr. Silver, call the office at 903-957-7246, fax us at 903-957-0049, or book your appointment online.