Herniated Disc: Will Epidural Steroid Injections Help A Herniated Disc?
February 8, 2008 · Print This Article
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
Clinical Specialist
Orthopaedic Physical Therapy
Get the latest back pain relief strategies delivered directly to your email inbox. It's fast. It's easy. And best of all it's FREE! Just enter your email address in the space provided to the left and click the subscribe me button. Thanks for visiting!
"
Wouldn’t chiropractic care help with this too?
Just curious.
Thanks for your question.
Although chiropractic adjustments are intended to take pressure off the nerve and, thereby, reduce inflammation, the reality is that sometimes the irritation will persist and needs a little “jump start” to effectively manage. That’s when an epidural injection would be warranted.
How painful are the ESIs and can you be put to sleep during the procedure. How much time do you need to be out of work afterwards?
Also, can a herinated disk heal if so how?
Vanessa,
Thanks for your questions. There is some evidence that herniated discs will heal but the process is very, very slow. What I believe happens is that the actual inflamed tissue no longer is swollen and inflamed, therby, eliminating the pain. Once a disc loses its ability to rehydrate, that disc ibasically is no longer viable.
As for ESI’s, there is some sting involved but that sensation quickly diminishes. The procedure literally takes less than 30 seconds so general anesthesia would be overkill. Following the procedure, you are monitored for about an hour to make sure there are no adverse reactions to the procedure. I’ve seen people return to work the same day, but most of the time they return to work the next day.