During an ESI, a combination of anesthetic numbing agents (such as bupivacaine or lidocaine) and long-lasting corticosteroids (such as betamethasone or triamcinolone) is utilized. These medications are carefully administered into the patient’s epidural space, which is the area between the bony vertebrae and the protective covering of the spinal cord known as the dura. This specific region is rich in tiny blood vessels and fat.

Corticosteroid injections are effective in reducing acute inflammation, and their direct delivery to the sensitive and painful area can provide significant relief. It’s important to note that while ESI does not actually shrink the size of a herniated disc, it can effectively target the affected spinal nerves. The pain relief experienced can vary in duration, lasting for days or even extending over years. This relief enables patients to improve the overall condition of their spinal cord and engage in physical therapy and daily exercise programs to further enhance their well-being.

ESI is highly beneficial for patients experiencing persistent pain in the neck, lower back, arm, or leg (sciatica). Individuals with any of the following conditions are particularly good candidates for receiving ESI:

Herniated Disc
A herniated disc occurs when the gel-like substance within a disc ruptures or bulges through a weakened area in the surrounding wall, known as the annulus. This can lead to swelling, pain, and irritation as the leaked substance comes into contact with the spinal nerve of the affected individual.

Sciatica
Sciatica is characterized by a severe pain that originates from the buttocks and travels down the leg along the path of the sciatic nerve. This condition is typically caused by the compression of either the first sacral or fifth lumbar spinal nerve.

Spinal Stenosis
Spinal stenosis occurs when there is a narrowing of the nerve root canal and spinal canal, leading to pronounced pain in the legs and back, especially during walking.

Degenerative Disc
Degenerative disc refers to the process of aging or deterioration of the intervertebral disc, which leads to the collapse of the disc space, the development of bone spurs, and the occurrence of tears in the annulus.

Spondylolysis
Spondylolisthesis is characterized by a fracture or weakness between the upper and lower portions of a vertebra. When the vertebra slips forward unintentionally, it can cause painful compression of the nerve roots.

ESI limitations exist primarily due to the potential side effects associated with the drugs used in the injections, rather than the procedure itself. Typically, ESIs are limited to a few times per year, depending on the specific situation and the advice of the doctor. This limitation is in place because these drugs have the potential to weaken nearby muscles and spinal bones. The more ESIs one receives, the higher the likelihood of experiencing these side effects. However, it is important to note that a lumbar epidural steroid injection is generally considered a safe and effective practice.

ESIs involve the use of medications that mimic the effects of hydrocortisone and cortisone, two key hormones in the body. When these drugs are injected near irritated nerves in the spine, they work to temporarily reduce inflammation and alleviate pain. However, steroid injections can disrupt the body’s natural hormone balance. To restore this balance, it is advisable to defer repeat injections and allow the body to return to its normal state.

When considering the long-term use of ESIs, it is crucial to carefully assess the potential risks and benefits. If you are experiencing significant pain between ESIs, it may be beneficial to discuss alternative treatment options for chronic back pain with your doctor. They can help guide you towards a comprehensive treatment plan that best suits your needs.

The frequency of performing ESIs for leg pain or lower back pain is not definitively established by research. In some cases, patients may receive up to three ESIs within a 6-month period.

Located in Metro-Atlanta, Comprehensive Medical Clinic is renowned for providing compassionate and respectful care to all our patients. We genuinely prioritize their overall well-being. Our clinic takes a unique approach to pain management by incorporating a range of minimally invasive techniques, ensuring the best possible outcomes for our patients. To schedule an initial appointment, please call 470-766-7246 or 470-7NO-PAIN today. We look forward to assisting you on your journey towards relief and improved quality of life.