Epidural Injections

Introduction:

Epidural injections stand as a pivotal intervention in the realm of pain management, specifically targeting chronic body pain arising from spinal cord inflammation. Composed of corticosteroids for long-term relief and local anesthesia for immediate comfort, these injections offer hope to patients grappling with conditions like spinal stenosis, disc herniation, and spinal injuries. In this comprehensive guide, we delve into the procedure, its applications, and associated considerations.

Key Takeaways:

• Epidural injections alleviate chronic body pain related to spinal cord inflammation.
• Corticosteroids and local anesthesia in the injection offer short and long-term relief respectively.
• Commonly treated conditions include spinal stenosis, disc herniation, and spinal cord injuries.

What conditions are epidural injections used to treat?

Epidural injections are primarily used to treat spinal stenosis, disc herniation, and other spinal cord or nerve injuries.

Epidural injections are used to treat or reduce chronic body pain associated with spinal cord inflammation. The injected fluid contains corticosteroids which are anti-inflammatory and a local anesthesia. During treatments, the injections are directed to the space around the spinal cord (epidural space). The anesthesia serves to produce temporary pain relief while the corticosteroids produce long term relief by eradicating the inflammation of the affected nerves. Usually, these are the nerves branching out of the spine.

Procedure

Patients are required to be available before the set time to prepare for the operation. This involves the cleaning of the injection site and a CT scan to allow the doctor to fully visualize the area and determine the cause of the pain. Fluoroscopy is utilized in guiding the needle into the epidural space. By using a contrast dye, the doctor is able to confirm when the needle is in the epidural space. After the confirmation, the doctor injects the corticosteroid and anesthesia solution into the patient. This procedure usually takes less than 45 minutes to perform.

• Use of the procedure: The primary conditions treated using the epidural injection include the following:
• Spinal stenosis: This is the abnormal narrowing of the spinal canal which can lead to the restriction of the spinal cord. Its location along the spine determines the area of the body that is affected. Most of the patients are affected in the back and the severity of the condition is varied. When stenosis advances, it can lead to the constriction of the spinal cord, and this can be very dangerous. Doctors use the MRI to diagnose the condition.
• Spinal disc herniation: This occurs when a tear in the intervertebral disc (fibrous cushion between bones) allows the inner contents to bulge out through the crack. This causes irritation to the adjacent nerves causing pain in that part of the spine. Not all patients with herniated discs experience pain. However, those who do, are advised to seek prompt medical care. Disc herniation, common in the legs and arms, is mostly caused by injuries, trauma, and advanced age. The injection of the epidural steroid decongests the epidural space and over time, the body is able to reabsorb the herniated material.
• Other injuries to the spinal cord/nerves: Neck epidural injections are effective in treating patients with any injury to the spine or the surrounding tissues. They also help ease chronic pain in patients who have undergone surgeries and are yet to heal.

The epidural injections are safe and deliver medication directly to the nervous system with minimal pain. The injected fluid can also function as a nerve block providing patients with immediate but short-term pain relief. Patients undergoing the procedure are requested to avoid food or fluid just before the treatment to prevent an upset stomach or compromising the use of sedatives should it become a necessity.

Risks and associated side effects:

There are close to no notable side effects associated with this treatment. However, following the procedure patients may experience nausea, headache and in some isolated cases, vomiting. Lack of sleep has also been reported by a number of patients but this improves with time. Like in all invasive treatments, there exists the minimal risk of secondary infections. It is thus advised to undergo the treatment in a credible medical center. All these should be discussed with your doctor before the commencement of the procedure.