A Statista survey supports the estimates of the medical community that around 29% of people in the U.S. have some form of back pain and believe that overwhelming stress is a major contributor to their pain. However, 26% blamed a lack of exercise and the same percentage blamed their type of work. As is demonstrated in this personal experience poll, back pain is a complex condition with many causes and therefore many possible treatments, one of which is the epidural steroid injection (ESI). Learning more about back pain and how epidural injections relieve pain can help you have the most productive conversation with David Berkower, DO, to get relief.
Here's what you need to know about this treatment option.
1. Back pain isn't just one thing
Some back pain is the result of inflammation of the nerves in the back. When your nerves feel inflamed, you have pain, numbness, and weakened muscles. All of this causes edema, which is fluid buildup in the area. People with this kind of back pain generally benefit the most from an epidural because the epidural works by reducing this inflammation and fluid retention, but if the pain has other causes, an epidural may be less effective. The inflammation may be caused by overuse, such as with construction work, but it can also be caused by underuse, such as when someone sits at a desk for long hours.
One group of researchers looked at over 70 studies done over the last several years and found that a therapeutic epidural steroid injection has varying levels of effectiveness depending on the type of back pain, including:
- Lumbar disc herniation – good effectiveness, but sometimes not enough to prevent surgery
- Spinal stenosis – fair outcome (some relief in some patients)
- Axial low-back pain and post lumbar surgery – poor or unable to verify outcomes
This potential lack of effectiveness in some patients is just one more reason it's so important to work with someone like Dr. Berkower who specializes in treating people with pain.
2. Epidural injections are usually a two-drug combo
Most epidural steroid injections combine two drugs, one of which is a local anesthetic such as lidocaine and the other is the corticosteroid. The lidocaine serves two purposes, which is to first provide you with some instant, much-needed pain relief in the area and secondly to ensure that the injection precisely hits its narrow target. This instant feedback that the injection hits the right spot is important because the second part of the combo offers longer-term relief by reducing inflammation and, in turn, reducing pain.
3. Epidurals can treat pain throughout the back
The most common use of ESI is in the cervical spine, which is your neck, but injections may also work on the thoracic spine (mid-back) or the lumbar spine (lower back). Depending on the type of back pain, Dr. Berkower may inject the epidural into the middle of the spine (interlaminar), or he may inject the left or right side (transforaminal).
4. Epidurals can reduce the need for back surgery
Researchers looked at over 26 studies to evaluate the effectiveness of the ESI in the prevention of the less desirable, more intrusive option of back surgery. They found moderate evidence that people were less likely to undergo surgery. The studies showed that most patients could put off an immediate surgery (within one year) by using ESI, and between one-third and one-half of patients were able to avoid surgery entirely.
5. Epidurals should generally be tried before opiates
While all medical procedures carry some risks, epidural injections are considered safer than opiates because of the addictive nature of these drugs. Insurance companies and Dr. Berkower explore ESI and other less risky options to avoid the need to take addictive drugs.
Dr. Berkower treats people, not back pain
Because each person is unique, the causes of their pain will be equally unique. Dr. Berkower recognizes that medical treatments should be as individualized as individuals. He treats people with back pain holistically with medications, exercise, and rehabilitation, and he works with you to find the best and least invasive treatment options. If you're suffering with back pain, know that surgery isn't your only option. Book online today.