Epidural injections are administered to patients suffering from back inflammation and/or pain. The medicine is delivered directly into the epidural space, the area surrounding the spinal cord and nerves. Epidural injections contain corticosteroid in them. Corticosteroid mimics the hormone cortisone and hydrocortisone, which reduces inflammation of the affected nerves, relieving pain albeit temporary. As with all medicine, it carries certain risks with it and although rare, is still a possibility.
As epidural injections are an invasive procedure, infections can occur at the injection site if the needles are unclean. However, this only occurs to 0.01% of all injections as needles are disposable and sterile nowadays.
An unintentional dural puncture can occur when the needle accidentally passes through the dura mater and into the cerebrospinal fluid. Patients will usually experience a post dural puncture headache which is normally delayed for between 24 to 48 hours and will typically last for 3 to 4 days. Anaesthetists will do a simple epidural blood patching by clotting the spinal sac and stopping the leak to treat severe cases of dural puncture.
Bleeding is a rare occurrence but patients with bleeding disorders are more prone to it as the injection might simulate bleeding.
Nerve damages are uncommon and rare, but can happen if the needle accidentally injures the nerves through trauma. Depending on the severity, it can be temporary or even permanent.
Depending on individual, some may experience allergy reactions due to the corticosteroid as their body is defending against these foreign intruders.
Apart from risks, side effects of the corticosteroid may also be experienced by patients. Common side effects include:
• Increase in pain at the injection site may be experienced by patients most commonly due to skin tissue irritation.
• Flushing of the skin due to their body reacting with the steroid.
• Patients may experience itchiness as their body’s defense mechanism is reacting with the steroid.
• Patients may sometimes develop fever due to infection at the injection site.
• Loss of sleep may occur to some as patients feel discomfort.
Epidural steroid injections are generally safe and are effective to relieve back pain. It is ideal for patients who do not wish to undergo surgery yet requires a long term solution to it. It is ideal for most patients except those with bleeding disorder. However, patients can only undergo the most 3 injections within a six months timeframe as the medication in each injection lasts more than 6 months.
ESI is extremely safe
Well, this is a misconception although it is true to a certain extent. Many people think that steroid injections are much safer than oral consumption of steroids. However, this really depends on the medication that is prescribed as the toxicity differs. While oral consumption of medication may cause irritation to the stomach and with the fact that it “travels” a longer distance down, there is a higher risk of allergy. However, ESI are injected directly into the affected area and when something bad occurs, it happens immediately without providing you much reaction time.
Repeated treatments are required for visible results
Many doctors tell their patients that a minimum of 3 ESI is required before they are effective. However, this is the average value comprising data from hundreds of thousands of patients worldwide. In fact, the exact amount of dosage required by each patient is never the same due to the differing genetics of each of us. Some patients get immediate relief after just a single injection while some may need a lot more to see results.
Multiple invasive sites are required
Most of us would have visited the hospital for one reason or another and a high percentage of us have had multiple needles injected into us. ESI are totally different from your usual invasive treatments. Only a single needle is required to be injected as ESI is done under the guidance of an X-Ray machine, providing the doctor with the exact spot to inject.
Immediate pain relief is obtained
While you may get immediate pain relief from the compressing of spinal nerves, you may suffer temporary pain in the form of bruises and tenderness due to the injection. Although the technique is conducted under the guide of an x-ray machine, human error is bound to happen. Bruising and swelling will go away on its own in just a couple of days.
Epidural Steroid Injections have been performed for a long time and it has a track record of being rather safe and successful. Since the procedure is an outpatient one, patients do not need to spend a night in the hospital, making it much more flexible and economical for them.