Sometimes, your back pain may be so bad that it begins radiating outward to your limbs. If that is the case, then aggressive medical intervention may be necessary if you want to recover or at least temporarily stop the pain while your body repairs itself.
To do that, you need to have what is called an Epidural Steroid Injection, or ESI.
What are Epidural Steroid Injections (ESI)?
Epidural Steroid Injections (ESI) are simple and effective non-surgical options for back pain management that involve the injections of steroids in the form of medication similar to cortisone. This is injected into the epidural space of the spine. The idea of this procedure is that the steroid medication will decrease inflammation and relieve pain. It is minimally invasive, and a common enough procedure.
What sort of pain requires an Epidural Steroid Injection (ESI)?
There are numerous reasons for an ESI to be used, such as:
1) Torn or herniated discs – when spinal disks get older, they lose their malleability and ability to absorb shock. This can end up in tears or ruptures, which can cause fluids to leak out and inflame nerve roots or the dura (spinal sheath) itself. This can cause pain to radiate outward through the affected nervous system. This is one reason why a neck or lower back injury can create pain that goes out towards the arms or legs.
2) Bone spurs – it’s possible that bone spurs can press against the nerve sheaths or the nerves themselves, causing injury or pain. This usually happens with arthritis, or its various sub-forms that can affect the spine.
3) Injuries – Spinal injuries due to accidents or overexertion can be severe enough to damage the spine that will require an ESI to make the inflammation subside.
How is it done?
The first step is to consult with your doctor, particularly if it is your first time. You may want to be sedated for the procedure, though this will require fasting for a certain period. Also, regardless of your physical health, you’ll need to be assessed before the procedure to minimize the chance of side effects or complications, particularly if you are on medicines that will affect your blood clotting ability. If you feel that you may need certain medicines, always clear it with your doctor.
Once your are sedated or given a local anesthetic, a thin needle will be inserted through the skin and mucscles directly into the epidural space. If this part of the procedure becomes painful at any point, you should tell your doctor, so he can adjust the level of your local anesthetic. A type of X-ray, fluoroscopy, will be used to position the needle carefully. Some medical dye (“contrast”) will also be used to target the area properly. After that,a local anesthetic and the steroid medicine will be injected.
After the procedure, you may feel as if the pain has immediately disappeared, but this is only the anesthetic effect. Steroid medication can take around three days to a week to be effective, and depending on the severity of your back or leg pain, may require more than one injection.