When treatments like medications and physical therapy don’t do enough to relieve your spine pain, an epidural steroid injection may help. Injections for back pain deliver powerful medicine at or near the source of your pain and often helps relieve spine pain for months.
Here are answers to some of the most frequent questions patients ask about injections for spine pain.
Q. How are epidural steroid injections for back pain used?
I recommend epidural steroid injections in many cases to treat nerve pain in the lower back. The most common causes of nerve pain our Denver spine surgeons see are:
- Sciatica: Stabbing, shooting that pain runs down one or both legs, usually along with a feeling of burning or tingling. (This really should be in parentheses after nerve pain above, since sciatica is not a cause but rather a type of nerve pain)
- Herniated disc: Discs are rubbery cushions between the bones in your spine. A herniated disc happens when some of the softer inner part of a disc pushes through a crack in the outer part and puts pressure on a nerve.
- Spinal stenosis: A narrowing of the spaces inside the spine that can cause pain, tingling, numbness, and muscle weakness.
Q. How does an epidural steroid injection work?
An epidural steroid injection relieves back pain by helping to decrease inflammation around the nerve. It usually contains:
- An anti-inflammatory medication called cortisone (a steroid)
- A numbing medication (lidocaine or bupivacaine)
The medication is injected into the space outside of the sac of nerves and spinal fluid. This is called the epidural space. Epidural steroid injections are the most common type of injection for back pain.
Q. How effective are epidural steroid injections?
Many of our patients get pain relief from epidural steroid injections. How well the injection will work for you depends on the cause of your pain and the specific nerve that’s causing the pain.
Often, our Denver spine surgeons know in advance whether an injection is likely to help you. Other times, you may need to try one and see if it helps.
Q. How effective are epidural steroid injections?
Many of our patients get pain relief from epidural steroid injections. How well the injection will work for you depends on the cause of your pain and the specific nerve that’s causing the pain.
Often, our Denver spine surgeons know in advance whether an injection is likely to help you. Other times, you may need to try one and see if it helps.
Q. How long does pain relief last?
I tell patients that pain relief from an epidural steroid injection can last from days to a year. Sometimes we can predict whether relief is likely to be long lasting.
Even if pain relief doesn’t last long, the injection can give you enough relief to make progress in physical therapy and help our Denver spine surgeons accurately diagnosis your spine pain. We use this information to recommend the best treatments for your spine pain.
Q. Does an epidural steroid injection hurt?
Epidural steroid injections don’t usually hurt. Before getting the injection, you will be given either:
- Local anesthesia: A numbing medicine injected near the site of the epidural steroid injection
- Conscious sedation: A combination of medicines to help you relax and block pain. You’ll be briefly asleep and won’t feel anything.
Q. How many injections can I have?
I don’t recommend more than three epidural steroid injections a year for any patient.
The number of injections is limited because steroids might weaken spinal bones and nearby muscles. Steroids also can cause side effects like hyperactivity, hunger, difficulty sleeping, skin thinning, or loss of color, facial flushing, and high blood sugar.
Even one epidural steroid injection has risks, including those mentioned above, but major problems are rare when an experienced doctor performs the injection. Infection and nerve root injury are very rare.
Q: Is everyone a candidate for injections for back pain?
Not everyone can get epidural steroid injections for spine pain. Pregnant women and people with an infection should never have these injections. People with the following medical conditions need to be carefully evaluated:
- Uncontrolled diabetes
- Congestive heart failure
- Bleeding disorder
- Significant allergic reactions to injected solutions
- Acute spinal cord compression
Epidural steroid injections will only be effective for some spinal conditions and every patient should be evaluated carefully. Our Denver spine surgeons at Neurosurgery One, can determine whether an epidural steroid injection might be an appropriate treatment for your spine pain.
Q: Are there other types of injections for back pain?
Yes. Other types of injections used to relieve spine pain include:
- Facet joint injections: Facet joints are small joints throughout the spine that can become painful due to arthritis, a back injury, or stress to the back.
- Sacroiliac joint blocks: The sacroiliac joint connects the bottom of the spine with the hip. Sacroiliac joint dysfunction occurs when the joint moves too much and causes pain.
