Understanding Epidural Spinal Injections: Is This An Alternative To Surgery?

Identifying Lower Back Pain

Lower back pain ranges from mild to severe and can interfere with someone’s daily activities or essential functions. Lower back pain affects the lumbar spine, the bottom half of the spinal column. These 5 bones protect the spinal cord and allow the body to walk, stand, and run freely. The lumbar spine has intervertebral discs separating each bone and nerves that connect to muscle and ligament tissues. Back sprains, strains, and injuries to these areas can lead to lower back pain. An epidural spinal injection may be an effective treatment for this pain.

Types of back injuries

The type of back injury or disease a patient suffers from directly impacts treatment options. These soft tissue injuries affect the muscles, ligaments, and tendons in the lower back. The intervertebral discs can flatten, enlarge, or tear and press against the nerves causing damage. Intense trauma, like a car accident, can lead to bone fractures. Tumors within the spinal column or cord will also contribute to back issues. These tumors can be cancerous or non-cancerous.

Diseases that lead to back pain

Some people are born with structural issues that affect the spine. Scoliosis is a disease that makes the spine curve and causes chronic back pain. Another disease, spinal stenosis, makes the spinal column too narrow to fit the spinal cord properly. The narrow spacing leads to irritated and pinched nerves. Osteoarthritis is a disease that breaks down joint tissues over time. The result is pain, stiffness, loss of flexibility, and inflammation.

Diagnosing lower back pain

Before doctors can treat lower back pain, specialists must identify the root cause of the issue. Physicians will perform diagnostic testing such as an X-ray, MRI, CT scan, electromyography (EMG), blood test, or urine test. Imaging tests like an X-ray or MRI let doctors view the bones, nerves, and soft tissues of the spine to detect injuries. Blood tests identify genetic abnormalities that lead to certain diseases, and a urine test reveals the presence of kidney stones that cause back pain.

Lumbar epidural steroid injection

This type of injection is used to treat lumbar radiculopathy, a medical term for chronic lower back pain. The steroid injection is a cortisone or corticosteroid medicine that reduces inflammation in the affected area. This intervention works best for spinal nerve irritation or damage. The steroid gets injected into the epidural space, a layer of tissues covering the spinal cord. The epidural space contains spinal nerve roots along with fat and arteries.

How does an epidural spinal injection relieve pain?

The cortisone or corticosteroid medication used in spinal injections mimics cortisol, a natural hormone the body produces. The adrenal glands produce cortisol to manage stress levels and reduce inflammation. Cortisol is vital to the central nervous system's function, which includes the spinal cord. The injection can relieve pain for 3 months or longer, and the procedure takes 30 minutes or less to complete. Usually, patients start feeling relief within a few days.

Speaking to a doctor

Patients considering an epidural spinal injection should consult a physician. A medical professional can perform the necessary tests to determine if this treatment is the right option for the patient's issue. Spinal injections can be performed by neurologists, surgeons, radiologists, and anesthesiologists.