Epidural Steroid Injection – Is It An Effective Treatment For Sciatica Pain

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What is an epidural steroid injection?

An epidural steroid injections form the most effective way of delivering steroids into the epidural space. This space is present in our spines, and there are actually very few methods that offer this level of penetration. However, a doctor may suggest some additional fluids to facilitate the flushing out of inflammatory mediators from the affected areas. In most cases, these fluids are local anesthetic combined with a normal saline solution.

For those who are unaware, the epidural space surrounds the dural sac, and mainly consists of small blood vessels and fat. This dural sac, on the other hand, is present all around the nerve roots, spinal cord and the cerebrospinal liquid. The later is the fluid in which nerve roots are soaked in.

The steroid injection ideally uses a solution that comprises of a steroid (usually cortisone) and a local anesthetic (bupivacaine or lidocaine). Here, your doctor may or may not decide to use saline.

Epidural Steroid Injection

Functions:

•    Steroids act as inflammatory agents, and cortisone functions to help reduce pain. Some other very commonly steroids are Dexamethasone and Triamcinolone acetonide.
•    Anesthetics offer temporary pain relief, and this is why lidocaine is used. Additionally, it is also known Xylocaine. Some anesthetics have a longer lasting effect, example Bupivacaine. Some health experts also recommend anesthetics to dilute the effect of chemical agents that enhance inflammation, and are therefore also referred to as flushing agents.
•    Lastly, saline works to further dilute the effect of the local anesthetic, and thus enhances the flushing activity carried out by it.

Using epidural steroid injection for inflammation control

Sciatica is one of the commonly treated conditions with epidural steroid injection. Sciatica pain originates from the site which houses a pinched nerve, and flows in alignment with the nerve. In addition to the usual reasons, pain within the body can also be generated by inflammatory chemicals as well as immunologic mediators. These are also commonly associated with some general back issues, like facet joint arthritis and lumbar disc herniation. All these, and some others, trigger inflammation within the body, which eventually results in considerable swelling and irritation of the nerve cells.

Steroids function by preventing the inflammatory response of the body which triggers due to the above mentioned mechanical and chemical sources. Another way in which these steroids function is by considerable reduction of the immune system activity. Ideally, our body initiates the generation of certain chemicals and white blood cells to counter the effect of foreign particles. Steroids block this activity, thus helping in reducing pain.

Success rates of epidural steroid injections

It must be mentioned here that the effects of these injections are never permanent, although they may range from a week to up to a year. Nevertheless, these steroid injections have proved to be very effective in issues related to the lower back.

How Can Epidural Steroid Injections Help?

•    Use of advanced technologies such as fluoroscopic guidance along with radiographic confirmation has helped numerous patients suffering from lumbar disc herniation get relief from the associated pain
•    Pain relief is largely achieved for leg pain, and then follows low back pain relief
•    Advantages of using epidural steroid injections offer a number of benefits, including the improvement of the sufferer’s mental health and overall life quality, as well as eliminating the need of using pain killing medications. Additionally, they may also help you postpone surgery, or in some cases, even prevent it altogether.

Despite its numerous benefits, some people are still concerned about the level of safety and overall effectiveness of the use of epidural steroid injections. In this regard, there is sufficient evidence to prove the fact that most of the controversies are generated by pathological reports. Moreover, if the injection is not directly given into the epidural space, the effect considerably diminishes.

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