An epidural steroid injection places this powerful anti-inflammatory medication directly around the spinal nerves. Traditionally epidural injections were administered without any special equipment, by inserting the needle by feel in the area around the spinal nerves. More recently epidural injections have been administered with the aid of imaging tools to allow your physician to see the needle going to the proper location. Either real-time x-ray called fluoroscopy, or CT scan can be used to 'watch' the needle deliver the medication to the proper location.
For many people, back pain goes away on its own or with nonsurgical treatments. Epidural steroid injections shouldn't typically be used as a first-line therapy for back pain relief, but that doesn't mean they can't play a role in treating pain. But injections won't cure the underlying cause of back pain, and they provide only temporary relief. Unfortunately, in many cases, chronic back pain can't be cured, but must instead be managed, like other chronic conditionsand patients must have realistic expectations of what epidurals can do.
Epidural injections are often used to treat radicular pain, also called sciatica , which is pain that radiates from the site of a pinched nerve in the low back to the area of the body aligned with that nerve, such as the back of the leg or into the foot. Inflammatory chemicals (. substance P, PLA2, arachidonic acid, TNF-α, IL-1, and prostaglandin E2) and immunologic mediators can generate pain and are associated with common back problems such as lumbar disc herniation or facet joint arthritis . These conditions, as well as many others, provoke inflammation that in turn can cause significant nerve root irritation and swelling.