By Richard Staehler, MD. Peer Reviewed. Video: Epidural Steroid Injections for Back Pain and Leg Pain A lumbar epidural steroid injection delivers steroid medication directly around the area that may be causing pain. Patel K, Upadhyayula S.
Epidural Steroid Injections. In: StatPearls [Internet]. Chang, Douglas, Zlomislic, Vinko. Chapter Lumbar Spinal Injections. In: Chapman, Michael W. Chapman's Orthopaedic Surgery.
Accessed June 26, Hassan KZ, Sherman Al. Epidural Steroids. Editor's Top Picks. It may also temporarily elevate blood pressure and eye pressure for patients with glaucoma. You should discuss this with your physician.
If you think you may be pregnant, tell the doctor. Fluoroscopy x- rays may be harmful to the baby. The doctor who will perform the procedure reviews your medical history and previous imaging studies to plan the best approach for the injections.
Be prepared to ask any questions at this appointment. Patients who take take blood thinning medication Coumadin, Plavix, etc. Discuss any medications with your doctors, including the one who prescribed the medication and the doctor who will perform the injection.
The procedure is usually performed in an outpatient center using x-ray fluoroscopy. Make arrangements to have someone drive you to and from the center the day of the injection.
At the time of the procedure, you will be asked to sign consent forms, list medications you are presently taking, and if you have any allergies to medication. The procedure may last minutes, followed by a recovery period.
The goal is to inject the medication as close to the painful nerve as possible. The type of injection depends on your condition and if you have metal rods or screws from previous surgery. The doctor will decide which type is likely to produce the best results.
Step 1: prepare the patient The patient lies on an x-ray table. Local anesthetic is used to numb the treatment area so discomfort is minimal throughout the procedure. The patient remains awake and aware during the injection to provide feedback to the physician. A low dose oral sedative, such as Valium or Versed, may be offered depending on the center. Step 2: insert the needle With the aid of an x-ray fluoroscope, the doctor directs a hollow needle through the skin and between the bony vertebrae into the epidural space.
Fluoroscopy allows the doctor to watch the needle in real-time on the x-ray monitor, ensuring that the needle goes to the desired location. Some discomfort occurs, but patients more commonly feel pressure than pain. There are several types of ESIs:. Step 3: inject the medication When the needle is correctly positioned, the anesthetic and corticosteroid medications are injected into the epidural space around the nerve roots. The shots may allow you to postpone or avoid surgery. But they may not improve how well you can do your daily activities over the long term.
If you don't have pain that spreads from your back down your leg, it's unlikely that epidural steroid shots will help at all. Epidural steroid shots are not recommended if you have general, or nonspecific, low back pain. The most common problem is a severe headache that lasts for a few days.
And your pain might get worse before it gets better. Serious side effects from an epidural steroid injection are rare. But they can include stroke, paralysis, or loss of vision. You may be able to relieve your symptoms by making lifestyle changes or trying other treatments, such as:. Your doctor may recommend the shots if you've already tried other treatments for at least 6 weeks, and if you have pain that spreads down your leg.
These stories are based on information gathered from health professionals and consumers. They may be helpful as you make important health decisions. I started feeling better soon after I had the shot. I was able to sleep through the night without waking up from pain. It really helped my energy level.
And I started taking short walks in the morning again. I have a really hard time in general recovering from procedures. I guess I'm just sensitive or something. Anyway, I'm concerned that the shots may involve more pain than they're worth. I'm going to see if my back pain gets better on its own before I decide to have these shots. I've had terrible back pain for a month or more, and now it's spreading down my leg.
I tried taking it easy, but that isn't helping. I've thought about getting the steroid shots. But I don't want to pay for something that might not last very long. My doctor said losing some weight and trying physical therapy could help my back pain. I think I'll try those things first. I work in a retail store, and I'm on my feet all day. I have a hard time getting through the day, because my back and leg pain is so bad.
I think the shots could help me, and I'm willing to try anything. I need to be able to do my job, and any pain relief would be a welcome thing. Your personal feelings are just as important as the medical facts. Think about what matters most to you in this decision, and show how you feel about the following statements. I don't care if the shots don't last. I want to try anything that might relieve my pain.
I'm worried about the serious side effects, like paralysis, even though they're rare. Now that you've thought about the facts and your feelings, you may have a general idea of where you stand on this decision.
Show which way you are leaning right now. How sure do you feel right now about your decision? Here's a record of your answers. You can use it to talk with your doctor or loved ones about your decision.
I don't want to try treatment that might not work or that won't last. Can the shots provide short-term relief from back pain that spreads down the leg? Are you clear about which benefits and side effects matter most to you? Do you have enough support and advice from others to make a choice? Author: Healthwise Staff. Medical Review: William H. Blahd Jr. This information does not replace the advice of a doctor. Healthwise, Incorporated, disclaims any warranty or liability for your use of this information.
Your use of this information means that you agree to the Terms of Use. Learn how we develop our content. To learn more about Healthwise, visit Healthwise. Healthwise, Healthwise for every health decision, and the Healthwise logo are trademarks of Healthwise, Incorporated. Updated visitor guidelines. Get the facts. Your options Try epidural steroid shots for low back pain. Don't try epidural steroid shots. Try medicines, physical therapy, and home treatment instead.
Key points to remember Epidural corticosteroid shots injections may give you short-term relief from back pain that runs down your leg. On average, pain relief from the shots lasts about 3 months. The shots probably won't help at all if you have general back pain or pain that does not spread down your leg.
0コメント