Epidural Injections as Pain Relief

November 12, 2012

Epidural Injections as Pain Relief

Epidural injections are recognized as a fundamental part of the non-surgical pain management in dealing with the pain from a lumbar spine disorder.

To treat radicular pain which is described by patients as a shooting, radiating pain which starts at the lower back and travels to the leg, epidural steroid injections may provide relief. This severe pain develops as a result of inflammation of a nerve or a lesion in the root of the spine.

The physical result of this can include the pain as described above, weakness in the muscles, deep tendon reflexes are reduced and dermatol hypesthesia.

An epidural injection, in comparison to oral steroids, allows the medication to be targeted to the affected area of the roots of the nerves. By carrying out this procedure unwanted side effects from the oral steroids are reduced. Studies have shown that epidural steroid injections are effective in treating severe inflammation in the root of the nerve.

The first report of an epidural injection being performed was in 1901. Cocaine was used in the injection in the treatment of sciatica and lumbago. From historical reports it appears epidurals were used with local anesthetic and large amounts of standard saline between the 1920s and 1940s. The first record of an epidural injection using corticosteroids in the epidural space in pain management for the lumbar area was in 1952.

Therapeutic and diagnostic benefits are gained using epidural steroid injections. From a diagnostic point of view the epidural injections aid in the identification of the space at the epidural as a possible generator of pain through pain relief after a local anesthetic injection to the site. If a patient is in receipt of frequent pain relief over a number of weeks it may indicate there was inflammation at the site which has been reduced. This may mean the damaged nerve roots were protected from the inflammation effects. Suffering from constant inflammation may lead to Wallerian degeneration and fibrotic alterations to neural tissues.

To achieve the best out of epidural injections reports state they should be combined with a spinal rehabilitation program which has been specially designed for the patient. For most patients who suffer this severe pain, epidural injections may be seen as an effective treatment option. This would only be considered after all the other treatments have been tried but with no success in relieving the symptoms. Other treatments include therapeutic exercise, manual and physical therapy and medication.

Some patients may not have to go through earlier treatments before receiving the epidural injections. This will be dependent on their current medical condition and what side effects may be experienced with other orally taken anelgesics. Also patients who are suffering extreme pain which reduces their ability to carry out the therapies above may be considered.

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