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Epidural Steroid Injection image

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"Epidural Steroid Injection"

The primary goal of treating chronic back pain with epidural steroids is to decrease the frequency and/or intensity of pain, and improve function overall.

This can be done with the use of an epidural steroid injection(s).  Perhaps your physician has already suggested one?  In conjunction with other forms of treatment, such as physical therapy, healing back pain and the eradication of symptoms can be hastened with an epidural steroid injection.

What is an epidural steroid anyway?

It is a very potent anti-inflammatory medication.  Usually the medication used is either triamcinolone or methylprednisolone.

How does an epidural steroid injection work?

When a physician injects an extremely potent anti-inflammatory into the epidural space, it can maximize the effect of the medication and potentially reduce the physical size of the nerve root in question.  And thereby reduce pain symptoms.

Who should get an epidural steroid injection?

People with a history of lumbar radiculopathy (bulging disc or herniated discs) and corresponding sensory changes (e.g. numbness) who have not yet responded well to conservative treatment alone.

It has been my clinical experience as a physical therapist that most people do well with an epidural steroid injection.  Rarely is there an increase in patient symptoms.  Usually, as the client responds, it will happen on the first or second injection.  Often, physicians do not administer more than a series of three injections, especially as they have been without benefit.

All though it requires greater skill, an epidural steroid injection done under fluoroscopy significantly improves correct needle placement.  So medication is placed where it counts!  At the same time, there is a decreased risk of a “dural puncture” as well since greater accuracy is increased.

Just be warned, not all physician practices are equipped with fluoroscopy capabilities and so he/she may prefer to sort of do it “on the blind.”

Mild complications following an epidural steroid injection do occur and can include headache (usually this disappears in 24 hours), and post procedure back pain near the injection site.

As you are experiencing back pain that is not responding to the usual medication and physical therapy intervention, consider an epidural steroid injection to put you on the right path to healing bulging disc pain faster.  Especially now that you know the facts.


Tommy Hoffman, P.T. By Tommy Hoffman, Licensed Physical Therapist


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