Epidural Injections

Epidural injection is a non-surgical treatment option utilized for relieving back pain. Spine degenerative conditions such as herniated disc, spinal stenosis and many others may induce back pain due to the compression of the associated spinal nerves. This pain or numbness may extend to the other parts of the body such as hips, buttocks, and legs. In cases where the patient finds no relief from non-surgical methods then finally surgery is recommended. 

Epidural injections are administered into the epidural space of the spine.  The epidural space is the space between the outermost covering of the spinal cord (dura mater) and the wall of the spinal canal. It is approximately 5mm wide and is filled with spinal nerve roots, fat and small blood vessels.

Indications

An epidural spinal injection may be employed both for diagnostic and therapeutic reasons, including:

  • Medications to determine the specific nerve root involved in the spinal problem (diagnostic purpose)
  • Medication for inducing short or long-term relief from pain and inflammation (therapeutic purpose)

It is to be noted that epidural spinal injection is not a curative intervention, rather it’s a treatment tool to reduce the discomfort of the patient so that rehabilitation programs such as physical therapy may be well executed.

Procedure 

Pain management in different conditions such as spinal stenosis, disc herniation and arthritis can be done through epidural injection. Different types of physicians such as physiatrists, anaesthesiologists, radiologists, neurologists, and surgeons may recommend epidural injections for pain relief.

Patients may feel some pressure during the injection, but mostly the procedure is painless. The procedure takes about 15-30 minutes to complete. After injection, the patient should not drive or go back to work and should rest and avoid any vigorous activities. Your surgeon may give specific post-care instructions.

Cervical Epidural

The cervical (neck and upper spine) epidural space is a portion of the spine in the neck where inflamed nerves can be located. It is a common source of a variety of painful conditions in the neck, including chronic pain.

A cervical epidural injection is a treatment in which a mixture of local anaesthetic and anti-inflammatory steroid is administered into the epidural space. The aim is to reduce inflammation and provide pain relief in the affected area of the spine.

lumbar epidural injections

Transforaminal Epidural Injection

A transforaminal epidural injection is the newest type of epidural steroid injection. It involves injecting steroid into the epidural space through the bony opening of the exiting nerve root, known as the foramen. It numbs your nerve, offers temporary pain relief and reduces inflammation.

Transforaminal epidural injections are done with a more diagonal approach than other epidural injections so that the affected nerve can be better treated. They allow the medication to be placed nearer to the area where the nerve is being pinched. They only target one side of your spine. These injections are also known as transforaminal epidural blocks.

When is a transforaminal epidural recommended?

A transforaminal epidural steroid injection may be recommended to help treat pain in your back, neck, arms, or legs. It can be used to relieve the pain from conditions including: herniated discs, degenerative disc disease, spinal stenosis, spondylolysis, sciatica and radiculopathy.

Translaminar Epidural Injection

A translaminar Epidural Injection is very similar to a transforaminal; however, it differs because of how it is delivered. Your specific condition will determine which approach the doctor takes when performing your Epidural Injection.

For translaminar procedures, the needle will be placed directly into the interlaminar space—that is, between the lamina of two vertebrae. This approach allows the injection to deliver steroid medication to the nerve root.

Thoracic Epidural Steroid Injection

A thoracic epidural injection is a shot that temporarily helps ease pain in your thoracic region. That’s the upper to middle part of your back. Medicine is injected into an area around your spinal cord. This area is known as the epidural space.

Your spinal cord is a delicate bundle of nerves that runs from your brain to your lower back. The nerves of the spinal cord allow your brain to communicate with the rest of your body. The epidural space surrounds the spinal cord. The spine or backbone is the hard structure composed of a column of many small bones (vertebrae). The bones of the spinal column help protect your spinal cord from injury.

Sometimes, nerves leaving the spinal cord can become pinched or inflamed. That might happen, for example, if part of an intervertebral disc presses into the space of the spinal cord and nerves. You may then feel pain in your back.

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