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All Posts Tagged: epidural steroid


What Is An Epidural Steroid Injection And Who Is A Suitable Candidate?

This is a common procedure for treating inflammation related to low back related leg pain, or neck related arm pain. In both of these conditions, the spinal nerves turn out to be inflamed because of tightening of the passages where the nerves travel as they go down or out of the spine.

Why There Is A Need Of Epidural Steroid Injections?

Tightening of the spinal sections can result from a range of causes, this includes disc herniation, bone spurs, thickening of the ligaments in the spine, joint cysts, or even unusual arrangement of the vertebrae. The epidural space is a fat filled that involves the spinal sac and gives cushioning to the nerves and spinal cord.

In this case, steroids put into the epidural space have a strong anti-inflammatory response that works in a way to diminish pain and enable patients to improve mobility. In spite of the fact that steroids don’t change the fundamental condition, they can work in a way to break the cycle of pain and inflammation and enable the body to compensate for the condition. As a result, the epidural steroid injections can give benefits that outlast the impacts of the steroid itself.

The Suitable Candidates for Epidural Steroid Injections

Individuals suffering from pain in the neck, arm, low back, or leg may turn out to be suitable candidates for epidural steroid injections. In particular, those with the following conditions:

Spinal Stenosis:

A tightening of the spinal canal and nerve root canal can result in back and leg pain, particularly when walking.


A weakness or fracture in the middle of the upper and lower facets of a vertebra. In the event that the vertebra slips forward, it can compress the nerve roots resulting in pain.

Herniated Disc:

The gel-like material inside the disc can result in bulging or rupture through a weak zone around the wall. Irritation, pain, and swelling happen when this material crushes out and interacts with a spinal nerve.

Degenerative Disc:

A breakdown or aging of the intervertebral disc resulting in the breakdown of the disc space, tears in the annulus, and growth of bone spurs.


Pain that progresses along the sciatic nerve in the buttocks and down the legs. It is normally resulted by compression of the fifth lumbar or first sacral spinal nerve.

The utilization of epidural steroid injections has demonstrated positive outcomes for certain patients in the treatment of painful inflammatory conditions. The injections can likewise help decide if surgery may be advantageous for pain related to a herniated disc. At the point when symptoms meddle with rehabilitative activities, epidurals can work in a way to ease the pain enough so patients can proceed with their physical therapy.

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What Is Epidural Steroid Injection and Why Do You Need Epidural Steroid Injections?

In order to diminish the inflammation and ease pain associated with nerve root compression, an epidural steroid injection is performed. A herniated disc, spinal stenosis, and bone spurs disorders can cause nerve roots compression. The inflammation takes place at the point when the nerve is compressed. This, as a result, can drive towards pain, numbness, tingling or faintness along the course of the nerve. This is categorized as radiculopathy. The objective of the epidural steroid injection is to help diminish the inflammation of the nerve root. The place of the epidural space is above the external layer and it surrounds the spinal cord and nerve roots. The epidural steroid injection is injection with the purpose to reach the epidural space, specifically over the compressed nerve root.

Why Do You Need Epidural Steroid Injection?

There are a number of reasons that can work in a way to narrow the spinal passages, comprising disc herniations, bone spurs, thickening of the ligaments in the spine, joint cysts, or even irregular alignment of the vertebrae. A fat filled ‘sleeve’ is the epidural space that covers the spinal sac and works in a way to give cushioning to the nerves and spinal cord. The pain can be decreased and an improvement in the functionality can be obtained as steroids (‘cortisone’) put into the epidural space because they have an exceptionally strong action. In spite of the fact that steroids don’t change the fundamental condition, however, they can work in a way to break the cycle of pain and inflammation and prepare the body to compensate for the condition. Thus, the epidural steroid injections can work in a way to give benefits that survive the impacts of the steroid itself.

Risks and Complications of Epidural Steroid Injections

The injections are generally safe with minimal risk of complexities. A standout amongst the most widely recognized risk is the accidental puncture of the tissue coving the spinal cord named the dura mater. In the event that this occurs, the liquid can spill out and result in a spinal headache. According to its name, headache is the essential side effect. Afterward, the injury is commonly treated with bed rest either or both a process is known as a blood patch in which blood is infused over the hole in order to form a seal as it coagulates.

On the off chance that the needle contacts the spinal cord or nerve root, it can result in short-term neurologic damage showing with numbness or tingling in the extremities points for a considerable length of time. With the arrival of X-ray-guided injections, the occurrence of this has dropped significantly.

On the other hand, allergic responses are uncommon, approx. 0.3 to 0.5% yet may require emergency treatment on the off chance that you go through wheezing, shortness of breath, hives, facial swelling, quick breathing, and a sporadic heart rate. Infection is likewise rare.

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This injection is a life saver!

As of late, there has been an expansion in media consideration with respect to the adequacy of epidural corticosteroid infusions, particularly for a condition called lumbar spinal stenosis. But, wait; let’s first explore what Epidural Steroid Injections are.

Epidural Steroid Injections

An Epidural Steroid Injection (“ESI”) is an injection with a blend of a corticosteroid and a neighborhood soporific drug, locally known as anesthesia. Corticosteroids are effective anti-inflammatory drugs that work to diminish swelling and aggravation helps taking away the weight off the nerves and other delicate tissues, bringing about noteworthy comfort. An ESI might be attempted when other non-operative medicines have neglected to diminish extreme back or leg pain from different reasons that lead to nerve irritation. These injections have been utilized for low back conditions since 1952 and are as yet an imperative piece of non-operative treatment designs. Relief from discomfort may keep going for a few days or even years. The objective is to diminish painful sensations with the goal that you may continue ordinary lifestyle and a non-intrusive treatment program.

Potential Risk Factors

The potential risks associated with inserting the needle include spinal headache from a dural puncture, bleeding, infection, allergic reaction, and nerve damage / paralysis (rare). Corticosteroid side effects may cause weight gain, water retention, flushing (hot flashes), mood swings or insomnia, and elevated blood sugar levels in people with diabetes. Any numbness or mild muscle weakness usually resolves within 8 hours in the affected arm or leg (similar to the facial numbness experienced after dental work). Patients who are being treated for chronic conditions (e.g., heart disease, diabetes, rheumatoid arthritis) or those who cannot temporarily discontinue anti-clotting medications should consult their personal physician for a risk assessment. Overall, this is a very safe procedure if it’s carried out appropriately.


Sensing the painful hints and its reaction are exceptionally individualized. Research to decide the viability of these medicines in the lumbar spine has demonstrated normal achievement rates between 50 percent and 90 percent. Numerous components impact the viability of Epidural Steroid Injections. Research has demonstrated that the sooner you get a dose for the pain, the better the result might be. To what extent help with comfort will last fluctuates with every patient.

The Expert

Choose your doctor effectively. Confused about who to contact? And what’s the best treatment for your pain? Contact Dr. Zaki Anwar! Dr Zaki is very experienced in interventional treatments. He is a world renowned Pain Medicine Physician and has been practicing ways to cure pain leading to serious problems for the past several years and has achieved remarkable results. Get his expert opinion by just making a phone call at 815-464-7212.

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Epidural steroid injection and your back pain

Epidural steroid injections are the most accepted therapeutic alternate for several kinds of back pain and leg pains. The epidural steroid injection has been used for decades as a remedy for back pain and has become a significant non invasive treatment for sciatica and lower back pain.

The basic purpose of epidural steroid injections is to provide temporary relief of lower back pain. In addition to relieving back pain the epidural steroid injections have worked wonders in treating cervical pain and pain in the mid of the spine

Conditions in which epidural steroid injections are helpful

Epidural steroid injections have proved to be helpful in several conditions that cause back pain either  it is chronic or acute back pain. Or pain arising from pinched nerves. The specific conditions may include;

  • Lumbar disc herniation; the nucleus of the disc leaks out from the outer hard surface and spreads into the spinal canal pinching the nerves
  • Degenerative disc disease; where the disc space is crumpled between the two discs causing severe pain  and inflammation by the pinched nerves
  • Lumbar spinal stenosis; where the spinal canal has been shrunk pinching the spinal nerves
  • Compression fracture; fracture caused due to severe injuries and lifting heavy weight
  • Cyst; tumors in the spine deforming the whole spinal structure
  • Annular tear; a painful, tear presented in the outer layer of the spinal disc

Epidural steroid injection procedure

The epidural steroid injection procedure is initiated by cleaning the targeted area, the injections may take 15 to 30 minutes and is followed by standard steps;

The patient is allowed to lay on the  examination table laying face down with a pillow beneath the belly to give it a slightly curved shape. If the said position causes pain, then the patient might sit or lie on a side in a little curled position The skin is cleaned and the patient is given with local anesthetic

The patient lies flat on an X-ray table or with a small pillow under their stomach to slightly curve the back. If this position causes pain, the patient can be allowed to sit up or lie on their side in a slightly curled position. The skin is cleaned and the patient is given with local anesthesia. The needle is injected using the X-ray guidance  directly into the epidural space. Once the needle reaches the correct position  a contrasting dye is  injected to make sure the needle has reached the correct position. The steroid solution is slowly injected which may be experienced by some patients as putting pressure on the spinal cord, however, the pressure felt by the patients are not usually painful. The patient is observed for 15 to 20 minutes after the procedure and is allowed to go home soon

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