“Relieving the burning or electrical type pain going down one’s arm or leg; often associated with a herniated disc”.
What is an Epidural Injection?
An Epidural Injection is an outpatient procedure that involves placing steroid and numbing medicine into the epidural space. (Epi= around, Dural= the covering of the spinal cord). Typically, this procedure is done for herniated discs (pinched nerves), which often result in electrical like pain shooting down one’s arm or leg. When a nerve is being pinched, that pinching occurs in the epidural space or close to it. For this reason, this is the area where the steroid is injected. The injection does not go into the spinal cord, or into nerve roots. The overall success of this procedure has consistently exceeded 75% in research studies for either neck, mid-back, or low back pinched nerve problems. In conjunction with additional therapeutic options, such as physical therapy, the non-operative success rates can achieve over 95% pain relief and avoid surgery!
The Epidural Injection is an outpatient procedure that takes about 30 minutes. After the procedure, the patient is able to go home within an hour. Depending on the body’s metabolism, the steroid may take 2-3 days to kick in. Studies performed regarding epidural injections show 75-90% good to excellent results. The Epidural injection relieves chronic pain. The injection contains a large anti-inflammatory agent and will bathe the inflamed and painful area with soothing steroid medication to provide pain relief. The hope is that the body will know that this piece of disc (herniated disc) is not supposed to be there and it will disintegrate it.
There are three different types of Epidural Injections
1.) Interlaminar 2.) Transforaminal 3.) Caudal.
- Interlaminar Epidural Injection:
The lamina is a type of bone on the back of the spine. (Interlamina= “between the two lamina”). The needle is injected into the epidural space; this introduces steroid medication and numbing. For over 60 years, Epidural injections have been done in the Interlaminar variety and are the most long lasting procedure variety.
- Transforaminal Epidural Injection.
This Epidural injection is closer to the problem area. The Foramen is where the nerve roots come out of the spinal canal. The steroid injection goes in the area outside the Foramen which is in the transforaminal area and usually where the nerve root is getting pinched.
- Caudal Epidural Injection.
This is when the needle goes into the bottom of the sacrum area. Numbing and steroid medicines are injected, and go into the lumbar area via gravity. Thus, reaching multiple areas to provide pain relief. The Caudal Epidural Injection is optimal for spinal stenosis where multiple nerve roots may be getting pinched.
Indications for Epidural Injections:
- Herniated disc with radiculopathy or sciatica
- Spinal stenosis
- Inflamed nerve roots due to degenerative disc disease
- Tear in the outer part of the disc- “annular tear”