The presence of a herniated disc is sometimes treated with epidural steroid injections (ESI). Epidural steroid injection is a nonsurgical approach to back pain used for both therapeutic and diagnostic purposes. Disc herniation and spinal stenosis can cause nerve irritation that usually results in back and leg pain.
The procedure involves the injection of an anesthetic (such as Marcane) and a steroid (usually DepoMedrol) into the spine for the purpose of shrinking swollen nerve tissue and reducing pain.
Usually 3 to 4 ESIs are performed over the course of 4 to 6 weeks. How the patient responds to the injections can help your physician determine the best course for future treatment.
One important comment here: If your physician recommends 1 injection a month, politely decline treatment. According to Dr. Michael Cronin of The Pain Institute in Louisville, KY, ESIs are most effective when performed 7 - 10 days apart as opposed to monthly.
The reason is due to the length of time the steroid is actually effective. Maximum benefit of an ESI is around 48 hours and is completely depleted by 7 days. At one month intervals, you would be basically starting over, making the entire process MUCH less effective.
In my experience, ESIs are only effective if the actual irritation is central (within the spine) as opposed to peripheral (outside the spine). An example of a peripheral problem would be a piriformis syndrome for which ESIs would be absolutely useless.
Hence, it is critically important that the patient be thoroughly evaluated prior to an ESI to rule out the presence of a peripheral problem.
You can read more about other non invasive treatment protocols to treat your back pain in my Back Pain Relief Secrets. Get your FREE copy here Back Pain Relief Secrets
As always, if you have questions or comments, let me hear from you by commenting below.
Dedicated to Erasing Your Back Pain,
Malton A. Schexneider, PT, MMSc
Orthopaedic Physical Therapy