An epidural steroid injection (ESI) are often performed
after a neck or back injury caused by a car accident or work comp injury. Many
of my clients simply agree to the procedure without clearly understanding an epidural
steroid injection and how it works. This
article will generally explain an epidural steroid injection, but you should
discuss it in greater detail with your doctor.
After a car accident or other injury, your neck or lower back
could be painful because of inflamed spine nerves caused by such things as a
herniated disc. An epidural steroid
injection (ESI) is a minimally invasive procedure that can help relieve this neck,
arm, back, and leg pain. The injection supplies medicines to the epidural space
– a fat-filled area between the bone and the protective sac of the spinal
nerves –to reduce the swelling in the area.
According to Mayfield Clinic, the epidural steroid injection includes both a corticosteroid (e.g., triamcinolone, methyl-prednisolone, dexamethasone) and an anesthetic numbing agent (e.g., lidocaine or bupivacaine). Unfortunately, the injection does not make a herniated disc smaller; it only works on the spinal nerves by flushing away the proteins that cause swelling. The pain relief can last from days to years, allowing your spinal condition to improve with physical therapy and an exercise program.
The doctor’s goal is to inject the medication as close to
the painful nerve as possible. With the aid of an x-ray fluoroscope, the doctor
directs a hollow needle through the skin and between the bony vertebrae into
the epidural space. Fluoroscopy allows the doctor to watch the needle in
real-time on the x-ray monitor, ensuring that the needle goes to the desired
location. For a neck injury, a cervical epidural steroid injection is
performed. The needle is inserted from
the side of the neck to reach the neural foramen to deliver the steroid
medication where the inflamed nerve root exits the spine. For a lower back injury, a lumbar ESI is
performed. The needle entry site is
slightly off midline of the back to reach the nerve canal to the inflamed nerve
Patients should schedule a follow-up appointment with the
referring or treating physician after the procedure to document the efficacy
and address any concerns the patient may have for future treatments and
expectations. For those who experience
only mild pain relief, one to two more injections may be performed, usually in
1-4 week intervals, to achieve full effect.
The injection does not fix the problem, however, it may relieve
the pain so treatment for fixing the problem can be performed. Physical therapy and/or home exercise program
to strengthen the back muscles and prevent future pain episodes is crucial to
long lasting pain relief.
According to the Mayo Clinic, epidural steroid injections are usually limited to just a few a year because there’s a chance these drugs might weaken your spinal bones and nearby muscles. Epidural steroid injections contain drugs that mimic the effects of the hormones cortisone and hydrocortisone. The injections could disrupt your body’s natural hormone balance. Thus, delaying repeat injections allows your body to return to its normal balance.
If you are having pain from a car accident and the doctor recommends an epidural steroid injection, talk to him or her about the chances of success and make sure you discuss combining the injection with some physical therapy or home exercises.
Attorneys Matthew Noyes and Lorrie Robinson help families who are impacted by a Tampa Bay car accident. Attorney Matthew Noyes even wrote a book on it – Do You Really Need An Attorney After a Car Accident. If you have questions are a car accident, call Personal Injury Attorney Matthew Noyes at 727-796-8282 or simply click here to schedule a free case consultation.