When to Consider an Epidural Injection for Neck or Back Pain
When back or neck pain interferes with your daily routine despite conservative treatment, an epidural steroid injection (ESI) may be a solution. That’s especially true if your symptoms are related to radiculopathy (pinched nerve).
Dr. Ike Malik of Texas Pain & Orthopedics in Pflugerville, Texas, is a double board-certified pain management specialist with extensive experience in treating neck and back pain. He’s committed to offering the latest and most effective treatments to help you live pain-free.
Here’s more information from Dr. Malik regarding epidural steroid injections and why he may recommend them for neck and back pain.
Understanding the role of nerves in back and neck pain
Your spine is an intricate network of bones, joints, discs, ligaments, and muscles that provide structural support for the body. It also houses and protects the spinal cord, which is the main highway of your central nervous system.
Highly sensitive nerve roots branch off from the spinal cord at points along the spine, most often threading through tiny openings called foramina. These nerves carry sensory (sensation) and motor (movement) information to and from the arms, legs, and other areas of the body.
When a disc bulges, arthritis develops, or inflammation sets in, the nearby nerves can become compressed and painful. Back or neck pain related to muscular tension or strain tends to remain localized. However, nerve-related pain may radiate (travel) to other areas.
For instance, in the neck (cervical spine), nerve irritation can lead to pain that radiates down the shoulders, arms, hands, or into the head. In the lower back (lumbar spine), it can cause pain that travels down the back of the leg (sciatica).
These symptoms aren’t just uncomfortable; they can limit movement, disrupt sleep, and impact your ability to work or enjoy daily activities.
What an epidural injection can do for back and neck pain
An ESI contains a potent anti-inflammatory (such as dexamethasone or methylprednisolone) that precisely targets inflammation irritating the affected nerves.
Reducing inflammation helps ease pressure on the nerves and relieves pain. Results typically occur within a few days, and pain relief may last for weeks to months.
When to consider an epidural steroid injection
Dr. Malik may recommend an ESI when:
- You have neck or back pain lasting more than a few weeks
- You have pain radiating into your arms or legs, suggesting nerve involvement
- Physical therapy, medication, and other conservative treatments haven’t provided relief
- Pain interferes with your daily routine
- You’re unable to rest or participate in rehab due to pain
You may also benefit from an ESI to reduce inflammation and nerve irritation after back surgery.
Conditions that may compress and irritate nerves include:
- Spinal stenosis (narrowing of one or more spaces in the spine)
- Degenerative disc disease
- Neuroforaminal stenosis
- Sciatica (compressed sciatic nerve)
- Facet arthropathy (degenerative arthritis of the facet joints)
- Vertebral bone spurs (bony overgrowth, often related to degenerative changes)
- Herniated or bulging discs
Because the space surrounding spinal nerves is minimal, even small changes, such as a vertebral bone spur (osteophyte), can press on and inflame nearby nerves.
What to expect before, during, and after an epidural steroid injection
At Texas Pain & Orthopedics, Dr. Malik performs a thorough evaluation that includes a physical exam and a detailed discussion of your symptoms before designing a personalized treatment strategy.
He can often identify an issue based on your symptoms and exam. However, he may recommend diagnostic imaging studies to confirm a suspected diagnosis.
During and after an ESI
An epidural steroid injection is an in-office procedure that takes 15-30 minutes. After applying a local anesthetic to numb the skin, Dr. Malik uses fluoroscopy (real-time X-ray guidance) to guide the needle into the targeted epidural space.
He then injects a combination of medications: a corticosteroid to reduce inflammation, and a local anesthetic (like lidocaine or bupivacaine) to provide immediate but temporary pain relief.
Most patients can go home shortly afterward. We generally recommend taking it easy for a day or two to allow the corticosteroid to take effect. Full results may take several days to a week.
Safety factors
ESIs are considered safe when performed by a qualified specialist and are generally well tolerated. Common, mild side effects include temporary soreness at the injection site or a mild headache. Serious complications are rare but may include infection, bleeding, or nerve injury.
The benefits of an ESI extend beyond local discomfort; it can significantly reduce radiculopathy, which includes such symptoms as numbness, tingling, or shooting pain that travels into your arms or legs.
Ready to learn more about ESIs?
We offer comprehensive pain management services, including ESIs when appropriate. Call our office at 512-738-8811 or use the online booking tool. We’re here to help.