What are epidural steroid injections for?

Epidural steroid injections – specifically corticosteroids – began to be used in the 1950s as an effective measure against the treatment of acute and / or chronic pain in the different segments of the spine, mainly in the lumbar region.

With the term epidural we refer to the space where the fat is located that helps protect the spinal cord from the movements of the spine. The application by injection is not the only way to use steroids for this purpose, since there are also possibilities for their oral administration, but their effect is not local. Instead, the epidural injection is placed right in the painful area and its effect is specific and immediate .

These corticosteroids produce, with their application, an anti-inflammatory effect in the area where they are applied, allowing to decrease in said region, the immunological action (acute or chronic inflammation) that is identified as the cause of the ailment. It is generally used together with other analgesics and ideally, fluoroscopy or X-ray examination should be used to determine the exact place where it should be injected, in order to perform a safer and more effective infiltration. By relieving the intense pain and thus the stress of the patient, the opportunity is opened to postpone and even do without a surgical intervention, depending on the diagnosed injury.

Finally, it is very important to clarify that the epidural steroid injection that we address here is totally different both in procedure and indications from the injection of anabolic androgen steroids, frequently used by bodybuilders, and epidural anesthesia, which is administered to some women. during the birthing process.

This is one of the most frequent uses of this procedure. Herniated discs are a mixed product of chronic systemic inflammation, which are also known as low-grade inflammation, and degeneration of the intervertebral discs, due to different variables depending on the person, such as obesity , inadequate hydration, sedentary lifestyle, poor posture and / or accidents, among others.

As we already mentioned, the effect of steroids is anti-inflammatory , by regulating the immune response that also participates in the activation of pain, in addition to mechanical pain. This application can mainly help to relieve pain in the back, legs and specifically in the sciatic nerve, since one of the most frequent causes of these symptoms is inflammation or wear of the intervertebral discs. The application of corticosteroid injection against lumbar disc herniation is the one with the highest percentage of effectiveness.

Lumbar spinal or vertebral stenosis is characterized by reducing the ducts or spaces that normally occupy nerves or blood vessels, facilitating their obstruction and strangulation, and with it, pain. Its causes are similar to those of herniated discs. However, there is an important difference with them: stenosis can not only occur at the intervertebral level but also by reducing the epidural space itself, thus limiting the spinal cord itself, with the risk of irritating and damaging it in the short and long term . For these types of injuries, epidural steroid injections can also be a good tool to relieve pain.

Some additional situations where an epidural steroid injection may be given are:

• Lumbar intervertebral disc tears
• Compression fractures of a vertebra
• Cysts or tumors in the vicinity that put pressure on the area
• Post-operative failed back syndrome: when there are injuries or discomfort in the area after a surgical operation
• Other nerve and vertebral injuries.

Sometimes this injection is used without sufficient tests as a tool to rule out possible causes of pain in the patient. Therefore, it is important to remember that for steroid injections to be more effective, the most recommended thing is to do a previous study by fluoroscopy and X-rays, in order to make sure of the lesion that is causing the pain, its exact location. and if it warrants infiltration.

Like any medical procedure, epidurals carry the possibility of side effects, although they occur much less frequently than oral administration and are also more effective:

Risks

The main risks depend mainly on a thorough previous medical observation and the adequate expertise of the professional who injects the patient. The risks are:

• Dural puncture : getting to ‘touch’ the dura, which is the meninx or barrier that covers the spinal cord, causing headache, which can last for a few days. Its incidence is less than 1%.
• Infections : less than 1% of cases.
• Bleeding : it can be caused by accidental damage to a blood vessel or by a bleeding condition of the patient that must be ruled out before injection.
• Damage to the nervous system : the nerves that communicate with the bladder and intestines may be affected, with the possible consequence of dysfunctions in these organs.
• Reaction or hypersensitivity to the drug.

Side effects

• Temporary and localized increase in pain.
• Insufficient immune response for the next 24 hours.
• Headaches (not due to dural puncture) and / or fever for the next 24 hours.
• Anxiety and insomnia .
• Facial flushing
• Hyperglycemia.

This article is merely informative, at FastlyHeal .com we do not have the power to prescribe medical treatments or make any type of diagnosis. We invite you to see a doctor in the case of presenting any type of condition or discomfort.

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