Epidural Steroids

          Epidural steroids have been safely and effectively used in the treatment of chronic neck and back pain for the last 40 years. Back and neck pain are usually treated conservatively with bed rest, physical therapy, non-steroidal anti-inflammatory drugs, back exercises and low dose narcotics. A majority of patients will improve on this regimen. However, when conservative therapy fails, epidural steroid injections are an effective next step in treatment.

          Epidural steroid injections work by several mechanisms. They break the cycle of pain, followed by muscle spasm, followed by more pain which occurs in this disease. Pain relief afforded by epidural steroids may allow a larger and more pain free range of motions. This increases the effectiveness of physical therapy in preserving muscle strength and range of motion.

          By administering a low dose, long acting medication, epidural steroids can effectively deliver the anti-inflammatory effect directly to the site of injury. This reduces the dose of medication necessary as well as increases its effectiveness.

           Epidural steroids are effective in the treatment of discogenic pain (bulging or herniated discs) in the back and in the neck. Epidural injections can be used to treat other problems such as sciatica, spinal stenosis, cervicogenic headache, failed back surgery syndrome and pinched nerves among other problems. They reduce inflammation, swelling and irritation of the nerves, thereby providing pain relief. Epidural steroids are simple and safe. The primary risk of the injection is headache which occurs in about 1 in 100 patients. Epidural steroids are safely performed by a pain specialist, usually an anesthesiologist.