How Do Epidural Injections Work?

When Dr. Nikesh Seth recommends epidural steroid injections for pain management to patients, many people give pause. Aren’t epidurals for women in childbirth? It’s a common misconception that experts at Integrated Pain Consultants are committed to debunking. Yes, “epidurals” are one of the most effective and well-known pain management tools in childbirth, but epidural steroid injections can actually be used to treat a wide variety of pain, including chronic pain. How does it work outside of the delivery room?

HOW EPIDURALS ARE USED TO TREAT PAIN

Epidurals deliver steroids into the epidural space located in the spine. In some cases, extra fluids such as a saline solution or local anesthetic may also be used to get rid of any inflammatory mediators in the region. Sometimes it’s these mediators that are a major cause of pain. The epidural space wraps around the dural sac and is full of blood vessels and fat. This sac encircles the spinal cord as well as nerve roots and the fluid that nerve roots rest in (cerebrospinal fluid).

CORTISONE STEROID INJECTIONS FOR PAIN

This type of epidural is usually comprised of a cortisone steroid and a local anesthetic such as lidocaine. The anesthetic helps to make the injection as comfortable as possible for the patient. The cortisone, or steroid, is an anti-inflammatory tool. Inflammation is a common cause of lower back pain. When you reduce the inflammation, you reduce the pain. Other common steroids include dexamethasone, methylprednisolone acetate, and triamcinolone acetonide. Lidocaine (also known as Xylocaine) is an anesthetic that works very quickly and is a great option for temporary pain relief as part of an epidural steroid injection. However, the anesthetic Bupivacaine lasts longer. More important than providing temporary pain relief at the injection site, the role of the anesthetic is flushing out those inflammatory mediators.

Most epidural injections last between two and five days. How many epidural injections you’ll need will depend on your body, your goals, and the degree of inflammation.

CONTACT NIKESH SETH, MD AT INTEGRATED PAIN CONSULTANTS

Epidural injections are not meant to be a permanent, long-term solution. After all, the pain is caused by inflammation if you’re being treated with epidural steroids, not something such as a broken bone that requires healing. Suffering from low back pain? Call Integrated Pain Consultants at 480-626-2552 and find out if an epidural steroid injection or another treatment is right for you.