Dr. Dinash Yanamadula, our board-certified pain management specialist at Princeton Pain & Spine Institute, offers epidural steroid injections for certain painful back conditions, such as low back pain caused by herniated discs, degenerative disc disease, sciatica, and spinal stenosis.
Here, he discusses how epidural steroid injections work and how safe and effective they are.
How epidural steroid injections work
Epidural steroid injections contain two medications: lidocaine, which numbs the area so you achieve immediate pain relief, and a corticosteroid, which has a longer-term effect by reducing inflammation.
Dr. Yanamadula inserts the solution directly into your epidural space — a narrow area in your spine that houses some spinal nerves and the dural sac (the outer covering of your spinal cord), as well as blood vessels, fat, and connective tissue.
The medication addresses your pain in several ways.
Stops nerve irritation
When your spinal discs degenerate or herniate, they release chemicals that irritate your nerves and cause pain. The steroids in the injection reduce or stop the release of those chemicals.
In the presence of injury and disease, your body produces inflammation that helps in the short term but eventually leads to pain. The epidural steroid injection can suppress the chemical mediators of inflammation to alleviate pain caused by swollen tissues.
The goal of an epidural steroid injection is to stop the pain, and one of the main ways it accomplishes this is by interrupting the spontaneous pain signals between your nerves and your brain.
In addition to stopping pain, epidural steroid injections’ goals are to improve your ability to function so you can participate in physical therapy and rehabilitation. These injections aren’t intended as a long-term solution but rather a short-term reprieve that enables you to heal.
Efficacy of epidural steroids
Some people experience immediate relief with epidural steroid injections; others feel no difference at all. Several factors influence the efficacy of epidural steroids, including your underlying condition, the technique used to administer the injection, and the type of steroid used. Studies show that success rates vary for different types of back pain:
- Lumbar herniated disc: up to 80% report 50% improvement
- Foraminal spinal stenosis: 87% get relief
- Axial low back pain: 68% have less pain and better function
- Neurogenic claudication: up to 53% report less pain
Other variables involve the frequency and the total number of epidural steroid injections given.
How many epidural steroid injections are safe?
In general, no more than three epidural steroid injections should be given in a 12-month period. However, some research indicates that you can receive an epidural steroid up to 6 times a year, but that’s the max.
If you have a positive response to your first injection, you can get a second injection when the results begin to wear off, which could be anywhere between a week and a year. Dr. Yanamadula guides you through the unique aspects of your case and advises you about the safest treatments.
Epidural steroids can reduce your need for oral mediation, which helps you avoid dependency, and they may help you delay or eliminate the need for surgery. To find out if you’re a good candidate, call or request an appointment online to consult with Dr. Yanamadula.