What is an Epidural Steroid?

Are you grappling with persistent low back pain and have been recommended epidural steroid, but are uncertain about their effectiveness? Concerned about potential long-term side effects? If so, read on.

Low back pain is a prevalent health issue affecting our present generation. Physicians attribute it to various factors, including the upright posture adopted by Homo Sapiens’, frequent hunching over while watching laptops, computers, and mobiles, as well as improper posture employed while during manual labor.

Diagnosing low back pain

Studies have shown that 90% of disc-related problems can be managed conservatively with just medications and do not require surgery. Removing discs doesn’t always resolve issues and can even cause instability in some cases. For a specific clinical profile of low back pain, a simple injection of steroids in the spine, known as an epidural injection, can be a viable solution.

How Does Epidural Steroid Work?

When a disc herniates, a spurt of local inflammation ensues and its like any other injury in any part of our body. However, the swelling from disc inflammation compresses nerves and nerve roots, triggering pain. Epidural steroids work by suppressing this inflammation. Some researches believe epidural steroid also works by suppressing the transmission of painful nerve pathways in the spine.

Is it Efficacious?

Regardless of the mechanism, epidural steroids have proven effectiveness, endorsed by many spine and pain societies when judiciously used for selected patients. It’s crucial to note that not all patients will benefit from it and some may indeed require surgery. Short-term efficacy of epidural steroid injections is well-established, especially for patients with sudden low back pain radiating to the legs. Epidural steroid injection when combined with medications, lifestyle changes, occupational therapy, weight reduction, physiotherapy, mind management can give definitely given long lasting relief.

Are There Long-Term Effects?

Previously, rare cases reported complications like weakness in the lower limbs, transient blindness, inability to speak, and disorientation. However, with the transition to preservative-free, non-particulate steroids, these complications have significantly reduced. Rather than focusing on complications, attention has shifted to identifying patients who would benefit from the treatment and who won’t. Patients with complete herniation, facet pain, or muscular pain will not benefit from epidural injection and it is advisable for patients to enquire from the treating doctor to rule these out.

Summary

Despite concerns raised about its safety, we assure you that epidural steroids can provide safe and effective way to short to long-lasting relief for carefully selected patients of low back pain with disc prolapse when administered by skilled pain physicians. Another noteworthy application is the use of epidural steroid in patients whose pain persists after surgery.

If you or someone you know is experiencing such low back pain, share your experiences in the comments section below. We might be able to provide them answers to their questions.

Dr. Milon V Mitragotri