Epidural Steroid Injection For Back Pain.

Back pain and the epidural steroid injection have become almost inextricably linked over the past few years, as these injections have frequently been used to ascertain the cause of backpain.

I myself have been subject to these as I'm guessing have many readers of this back pain blog. I have to say in my own case to no great effect as a diagnostic tool.

An epidural steroid injection (ESI, yes yet another acronym) is probably the most common injection given to back pain sufferers.

As we all know back pain is notorious in that it can be an excruciating and debilitating condition for a while and then, for no particular reason that we can see, will disappear of it's own accord. The sufferer may never have another attack. Or it may reoccur within days, weeks , months, or indeed years.

Chronic back pain however does require medical intervention, especially in cases where there is difficulty in passing water, numbness in the back or genital area, pain and weakness in the leg(s), or an unsteady feeling whilst standing. In these cases a swift visit to the doctor is called for.

Patients in this condition are very often given spinal injections for two reasons. One to find out the actual cause of the pain, and two, to treat it. Injections used to provide relief (albeit temporary in most cases) are referred to as therapeutic injections. Those used as a diagnostic tool are generally ESI's.

The epidural space is the space between the spinal cord, well strictly speaking the covering of the spinal cord, and the inside of the spinal canal. Injections into this space does ensure that any medication is able to cover all the nerve routes to give back pain relief. So ESI's are a very effective treatment and diagnostic tool.

As many readers will be aware, spinal injections of this type can be very painful in their own right, so in most cases where they are used a prior injection of the local anaesthetic lidocain is administered first. This is harmless, fast acting, and wears off usually within a couple of hours or so.

Epidural steroid injections are usually given in one of three different ways. The most commonly used method when looking to reduce back pain is what is called the translumbar approach. Here the needle is positioned between the vertebrae from the back.

Another method is when a caudal block is placed through the sacral gap (the space below the lumbar spine) and the injection is then administered into the epidural space. This method greatly reduces the chance of the needle puncturing the covering of the spinal cord (the dura).

The third way is more of a diagnostic method, involving injection around specific nerve roots to determine the exact area where the problem lies. There are a few instances where the use of spinal injections are contra-indicated, such as in the case of those taking platelet-inhibiting drugs like aspirin or non-steroidal anti-inflammatory drugs (NSAID's, don't you just love all these acronyms?).

Although this technology is by medical standards now quite old it still has a valuable role in many cases of chronic back pain. If you want to learn a bit more try this link.