Does Your Back Pain Need Surgery?

Chronic back pain affects more than 23% of American adults. For many, the pain is a sign of a serious underlying condition related to the spine. If left untreated, the pain can worsen, producing additional symptoms that severely limit everyday activities. There are surgical and non-surgical options for patients eager to address the issue. Epidural spinal injections (ESI) are a great option to consider, producing long-term relief for back pain. In some cases, a spinal injection can be an alternative to surgery.


Back pain causes

The spine consists of 33 interlocking bones called vertebrae. Between each pair lie discs that help with shock absorption and movement. Sometimes, the bones or discs can change, leading to unpleasant sensations. For instance, the discs can degenerate or shift out of place over time due to injury or wear and tear. The bones can also degenerate due to arthritis, or there can be lumbar spinal stenosis, a narrowing of the spaces within the spine. These conditions can cause pressure on nearby nerves, leading to back pain, leg pain or sciatica, stiffness, and weakness. If these symptoms impact the quality of life, a doctor can help with treatment.

A shot into space

Most doctors will start back pain treatment with non-surgical options like physical therapy (PT) or pain medication. However, an epidural spinal injection can help with moderate to severe pain. The technique begins with a doctor, neurologist, or pain management specialist injecting pain medication and steroids near the spine. The medicine goes in the epidural space, a tiny gap between the spine and vertebrae. Over time, this approach to pain management will reduce inflammation and pain and help the patient function. Epidural spinal injections help both herniated discs and bone-related conditions.

What to expect during ESI

Epidural spinal injections are minimally invasive, meaning the patient can leave on the same day. The process begins with the patient changing into a gown and lying face down on an operating table. The doctor or pain management team will numb the area and then use fluoroscopy to guide the injection. The doctor will then inject the medicine in the designated space. ESI can occur near the lamina, intervertebral foramen, or sacrum. The procedure takes less than an hour to complete. The doctor and patient will then gauge the degree of pain the patient experiences after the injection.

Success and complications

Epidural spinal injections have a high success rate. The procedure is valued as a solution for moderate to severe pain that does not respond to other methods. However, like any procedure, epidural injections run the risk of complications. Most patients feel added pressure and discomfort immediately after the injection, but symptoms should subside after a few hours. Other complications include headaches, infections, damage to the injection site, and bleeding.

Can ESI replace surgery?

In many cases, an epidural spinal injection can provide significant relief. However, the results aren’t permanent, and patients may experience pain again. Moreover, doctors place a limit on how many spinal injections patients can have yearly. This is due to the increase in complications and a reduction in the efficacy of the procedure with continued injections. For patients with mild to moderate pain who see an immediate improvement, spinal injections can help. However, if multiple approaches fail, surgery can provide long-term or even permanent relief. Furthermore, if there is severe damage to the spine or the patient loses bladder control or has weakness in the leg, surgery is the best option.

Take your best shot

An epidural injection in the spine is an excellent option for chronic back pain. The procedure provides immediate relief as the doctor delivers steroids and medication directly to the impacted nerve. An ESI, along with lifestyle changes and therapy, can be enough to provide long-term relief. However, if the pain persists or the patient has had multiple injections, an alternative procedure may be required. The patient may need surgery to remove part of the disc or bone. A doctor can provide guidance on the best course of treatment to limit complications and give the patient the best options for a healthy life.

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