Epidural Steroid Injections

Epidural steroid injections (ESIs) are a common treatment option for many forms of low back pain and leg pain.

WHAT ARE THE BENEFITS OF ESIs?
As part of the non-surgical management of sciatica and low back pain, an epidural injection containing steroids, anesthetics and ant-inflammatory medications can be very beneficial for a patient during an acute episode of back and/or leg pain. The effects of an injection tend to be temporary-providing relief from pain for one week up to one year. At times the injection alone is sufficient to provide relief, but commonly an epidural steroid injection is used in combination with a comprehensive rehabilitation program to provide additional benefit.

HOW DO ESIs WORK?
Epidural steroid injections deliver medication directly to the source of pain generation. They can help control local inflammation while also “flushing out” inflammatory proteins and chemicals from the local area that may contribute to pain. Steroids inhibit the inflammatory response caused by chemical and mechanical sources of pain, while also reducing the activity of the immune system to react to inflammation associated with nerve or tissue damage. The procedure usually takes between 15-30 minutes. First the skin is cleaned and numbed with a local anesthetic. Using fluoroscopy for guidance, the doctor will insert a needle the skin and direct it toward the epidural space. With contrast dye, the doctor will then confirm the needle is placed in the epidural space. Once the needle is in position, the doctor will inject a solution into the epidural space.

WHY ARE EPIDURAL INJECTIONS CONSIDERED MEDICALLY NECESSARY?
-ESIs can provide a few weeks of partial pain relief while the patient hopefully awaits spontaneous resolution and improvement.
- An ESI may provide short-term improvement in successfully accruing sufficient time to ascertain whether conservative care will succeed.
- Each injection will be scheduled separately and effects of each injection will be evaluated depending on patient response (improved function and pain reduction). 
- It is an option for radicular pain syndromes lasting at least 3 weeks having been treated with non-steroidal anti-inflammatory agents (NSAIDS) like ibuprofen and without evidence of a trend towards spontaneous resolution.

WHAT ARE SOME COMMON USES FOR ESIs?
Common conditions that cause severe acute or chronic low back pain and/or leg pain from nerve irritation that can be treated by steroid injections include:
-Lumbar Disc Herniation
-Degenerative Disc Disease
-Lumbar Spinal Stenosis
-Compression fractures in a vertebra
-Cysts in the facet joint or the nerve root that can expand to squeeze spine structures
-Annular Tear

WHAT IS THE SCIENTIFIC EVIDENCE BEHIND THE USE OF EPIDURAL INJECTIONS?
Dr. Datta has published extensively on systematic reviews, and his article is enclosed for review of the scientific evidence on the role of epidural injections.

For more information consult with the experts at Datta Endoscopic Back Surgery and Pain Center at 347-380-9138 or click here and enter your information: http://backsurgeryandpaincenter.com/contact-us. You can also send a message to info@backsurgeryandpaincenter.com

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