See also: Epidural interactive videos
Dr. Ron linehan, MD, board-certified pain management expert

Epidural steroid injections are a safe, effective and minimally invasive means of controlling spine and extremity pain caused by bulging discs, surgical scar tissue or degenerative disc changes. These injections control pain by reducing inflammation and swelling. Rather than simply masking the symptoms, epidural steroid injections address the actual cause of pain and can control symptoms for prolonged time periods.

Translaminar or Transforaminal Approach

The goal is to inject the medication as close to the pain source as possible, using either a translaminar or transforaminal injection. The correct type of injection depends on your condition and which procedure will likely produce the best result

You may experience a brief increase in discomfort for one to two days after the injections. However, the steroid injection will reduce inflammation and pain after two to three days. Most patients experience a 50 percent or greater reduction in radicular pain that lasts for weeks to years.

Translaminar Approach
The translaminar approach is used when a patient has pain radiating from the back into both the left and right lower back, buttocks and legs—both extremities, and have not had prior back surgery. This approach typically does not require fluoroscopic guidance. The injection is delivered in the middle of the back between the vertebra directly into the epidural space (outermost part of the spinal canal). See: Translaminar Approach Video

Transforaminal Approach
The transforaminal approach is used when a patient has pain radiating from the lower back into only one side of their extremities, and have previously had back surgery with probable scar tissue formation. Fluoroscopy—a type of X-ray video imaging—is used to guide the injection to the affected nerve roots. The injection is delivered into the opening at the side of the spine where a nerve root exits the spinal cord. See: Transforaminal Approach Video

Reasons for Needing an Epidural Steroid Injection?

If you have intense, difficult-to-treat pain in your legs or arms from inflamed spinal nerves, then an epidural steroid injection might give you quick relief. Often, nerve passages from the spine to your arms or legs become narrowed, causing this pain. This narrowing can cause inflammation of the spinal nerves.

A number of conditions may add to this narrowing, including:
• Herniated, torn or ruptured disks
• "Slipped” vertebrae
• Degenerative disc disease
• Joint cysts
• Bone spurs
• Thickening ligaments in the spine because of spinal arthritis

Risks and Side Effects

Epidural steroid injections are safe and unlikely to result in a complication. Approximately 10 percent of patients may experience side effects that last a few days following the injection, including:
• Hyperactivity, sleeplessness
• Lethargy, drowsiness
• Headaches
• Mood swings
• Night sweats
• Temporary increase in appetite
• Temporary increase in blood glucose levels (diabetic patients)
• Fluid retention
All of these side effects are temporary and generally last no longer than two to three days. Precision Pain Care can treat more serious side effects with medications.

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