Nonsurgical Relief for Neck & Back Pain

By: Jamie O. Edwards, MD

Epidural steroid injections (ESIs) commonly treat acute or chronic neck and low back pain and related nerve irritation symptoms like numbness and tingling in the arms and legs (sciatica).

Several common conditions that cause nerve irritation can be treated with ESIs including disc displacements (slipped or herniated), degenerative disc disease (age-related wear and tear), disc tears, and stenosis (narrowing in the spine).

“ESIs have been in use for over 50 years,” says Jamie Edwards, MD, Spine Specialist. “The greatest success has been during the last 15 years. Advances in image guidance allow for better accuracy and improved safety.”

Benefits of ESIs

“The primary goal of ESIs is to flush out the swelling around the irritated nerve of the spine and provide pain relief by decreasing inflammation,” says Dr. Edwards. “This can aid the body’s ability to heal displaced discs and reduces inflammation around age-related narrowing of the spine.”

“ESIs also provide sufficient pain reduction so that patients can participate in rehabilitative exercise programs. The rehabilitation helps patients regain global spine health and help prevent further episodes.”

How They Work

Anti-inflammatory medication is delivered to or very near the spinal source of pain through the ESI, offering a more direct method than taking oral
pain medications. Oral steroids are not as focused and may not penetrate a spine that is blocked by swelling. ESIs often allow reduced use of narcotics,
muscle relaxants, and nerve medications. This results in fewer side effects and lower risks for medication dependency.

ESIs are generally very safe, invasive medical procedures in healthy individuals, but may not be appropriate for those with active infection,
pregnancy, spinal tumors, and prolonged bleeding disorders. Potential risks include infection, nerve/blood vessel injury, stroke, death, and blindness.

“These risks are extremely rare – less than one percent – and when utilized correctly, they do not outweigh the benefits,” says Dr. Edwards.