Epidural steroid injections are used for low back pain since 1952 and are still an integral part oft he non-surgical pain management of sciatica and low back pain.
Spinal injections can be used in two ways. First, they can often confirm and localize the source oft he pain. Second, they are therapeutic in that they relieve the pain.
The effect may be temporary, in less severe cases it often provides long lasting pain relief.
Even if not lasting, the injection can be very beneficial for a patient during an acute episode.
Spinal injections are often used prior to major surgery to confirm the origin oft he pain.
Transforaminal epidural steroid injections or selective nerve root blocks are given for two major pain problems: radiculopathy (sciatica) and spinal stenosis.
These conditions usually occur in two areas: the neck and the lower back. They can cause neck or lower back pain and may radiate into arm or leg.
Compression of the spinal cord (myelon) or nerve root by a herniated disc or osteophytes (bone spurs) leads to inflammation, which is adressed by the steroid.
Injections deliver medication directly to the source oft he pain. In contrast, oral steroids have a dispersed, less focused impact, need higher dosage and may work less effective whilst they may have side effects. Injections don´t work as a simple painkiller, but reduce inflammation and swelling oft he nerve.
The injection does not widen the narrow spinal passages, but it indirectly reduces the diameter of the formerly swollen thick nerve. The nerve has enough space again, it is not compressed anymore, the pain resolves.
Patients who have had back surgery may also benefit from the injection, if they suffer from scar tissue pressing on the nerve root or a recurrent slipped disc.
The injections can be given CT-guided, under fluoroscpy or in patients with a normal anatomy of the spine as well without thechnical support (by palpating anatomical landmarks).
Spinal injections are not used for non-specific low back pain.
CT-guided epidural injections are given by Dr. Döbber in Hamburg or Elmshorn.
Read more under orthopaedic therapy.