Manhattan Wellness Group

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PAIN MANAGEMENT SPECIALIST 

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Epidural Steroid Injection

Many spinal conditions, including a lumbar herniated disc, can cause inflammation or pressure on the nerve roots leading out of the spine, resulting in pain, tingling, or numbness along those nerves.A lumbar epidural steroid injection may be used to reduce the inflammation around the spinal nerves. During the procedure, the patient lies down with a cushion underneath their stomach to increase flexion in the lumbar spine, giving more room for the needle to pass through.

Epidural Steroid Injection Treatment Process

A local anesthetic is used to numb the skin above the injection site. Using X-rays, the needle is guided into the epidural space. Contrast dye is injected to confirm the proper placement of the needle in the epidural space. The injection itself may include local anesthetic and/or saline along with the steroid medication to give immediate pain relief and flush the area of inflammatory agents.

The mixture is injected and the steroid acts to reduce the inflammation around the spinal nerve roots. After the needle is removed, a small bandage is placed on the injection site. The patient is monitored for a short time before being discharged home.

An epidural injection delivers steroids into the epidural space around spinal nerve roots to relieve pain - back pain, leg pain, or other pain - caused by irritated spinal nerves. The steroid used in the epidural steroid injection reduces the inflammation of those nerves, which is often the source of the pain. It is important to note that an epidural steroid injection should not be considered a cure for back pain or leg pain: rather, the goal is to help patients get enough pain relief in order to be able to progress with their rehabilitation program.

Anatomy of the Spinal Nerves and Dura

There is a membrane called the dura covering the nerve roots in the spine. Around the dura is a sleeve-like space called the epidural space. Before nerves can travel from the spine into the arms, chest, and legs, they travel through the epidural space, and exit through small nerve holes. The medication from the epidural steroid injection is placed in the epidural space

What Are the Symptoms of Disc and Bone Spure Damage?

Spinal nerves can become inflamed due to irritation from a damaged disc or from contact with a bone spur. Depending on which part of the spine the inflamed nerves are located in, pain and/or other symptoms (such as numbness, tingling) may be experienced in different areas of the body.

Nerve irritation in the cervical spine

Nerve irritation in the thoracic spine

  • Upper back pain
  • Pain along the ribs to the chest wall
  • Pain in the abdomen (rarely)

Nerve irritation in the lumbar spine

  • Low back pain
  • Hip pain
  • Buttock pain
  • Leg pain, or numbness, tingling

Steroid Injection Results

An epidural steroid injection significantly reduces pain for approximately 50% of patients. It works by delivering steroids directly to the painful area to help decrease the inflammation that may be causing the pain. It is thought that there is also a flushing effect from the injection that helps remove or "flush out" inflammatory proteins from around the structures that may cause pain. In addition to relieving pain, the process of natural healing can occur more quickly once the inflammation is reduced.

 

 

At Manhattan Wellness Group, Dr. Ayman Farag, who specializes in Epidural Steroid Injection Treatments, has been in practice for more than 20 years.

Dr. Ayman Farag is a board-certified anesthesiologist and licensed medical doctor.

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