Spinal injections for back pain Part 2

Epidural injections are done as outpatients and either performed by an anesthesiologist or a physician who is familiar with this procedure. The technique is pretty simple. One lies down on a flat table with the knees folded towards the chest. This helps open up the disc spaces and then the needle is guided into the epidural space. When done well, it is a relatively painless procedure. Sometimes, there may be difficult guiding the needle into the epidural space and one may to perform the injection under X ray guidance.

Once the steroid is injected, it migrates to where the nerve roots are located and starts to work by decreasing inflammation. The pain relief is gradual and not immediate.

Epidural injections also have a fair share of side effects that include:

- Back pain at injection site. The pain is mild in
most cases and resolves in a few days. However,
some individual have prolonged pain at the injection
site.
- Very rarely some individuals may develop nausea,
vomiting or abdominal cramps. These side effects
resolve in a day or two.
- Some individuals do develop light-headedness and
some feel dizzy. Some individuals do complain of a
headache which may last anywhere from a few days to
several weeks.

When many epidural steroidal injections are performed, the following complications may occur:

- Loss of bone density, leading to osteoporosis
and possible bone fractures
- Easy bruising of skin
- Decreased muscle mass and strength
- Increased susceptibility to injections because of
suppression of the body’s immune system

The most common drug used for epidural injections is a corticosteroid. Corticosteroids are potent ant inflammatory agents, reduce inflammation, and nerve irritation. While they do relieve pain, the injections do not work in everyone with back pain. Even the degree of pain relief is not the same in all individuals

Clinical data indicate that less than 10-30 percent of individuals get decent pain relief. The pain relief only lasts from a few weeks to a few months. Epidural injections for back pain are not curative.

The cost of an epidural steroidal injection varies but generally is more than $2000. The cost is often not covered by many medical insurance health carriers.