If you have already exhausted all means to manage your back pain to no avail, your physician may recommend you a non-surgical option—epidural injection for back pain. Epidurals can be used pre- or post-surgery, either as an anaesthetic or painkiller. Specific types are exclusively used for back pain.
This blog will explore how an epidural injection for back pain work, including its types, benefits, and side effects.
Table of Contents
What is an Epidural Injection for Back Pain?
Epidural Steroid Injection (ESI) is a popular pain relief option for chronic back pain, wherein an anti-inflammatory drug is injected into the epidural space (which surrounds the spinal cord) to provide short- or long-term pain relief. This uses a special needle called epidural or spinal needle.
This is usually recommended if you have sciatic pain, the type of pain that radiates from the lower back to the hips and legs.
What to Expect During the Procedure?
Your healthcare provider will first decide on the injection site. It is usually a space in the lumber spine but can be administered anywhere from the neck to the lower back, depending on your condition. An X-ray or MRI is usually done for an accurate diagnosis.
- You will lie on your stomach or side on a straight treatment table
- Your doctor will clean and numb the target site
- Using fluoroscopy (X-ray guidance), the needle will be inserted into the epidural space
- A contrast dye is injected to confirm accurate placement
- The steroid is injected
The whole procedure usually takes around 15 to 30 minutes.
What are the Types of Epidural Injections?
There are two types of epidural injections for back pain:
- Single-injection epidurals – Used for one-time administration. Most providers inject corticosteroids using this method.
- Epidurals with PCA (Patient-Controlled Analgesia) are mostly used for pain relief after surgery. A catheter is inserted and left in the epidural space, and a handheld device controls the amount of analgesia. This method offers safe and controlled administration of painkillers.
Dr. Yasser Mehrez offers fluoroscopic guided injections for pain relief management at his private clinic. These injections are safe, effective, and precisely targeted.
Which Conditions is an Epidural Used For?
Common conditions in which an epidural is used are:
- Chronic back pain management
- Pain relief in herniated or bulging disc conditions
- Labour pain relief
- Pain management after surgery
What are the Benefits and Drawbacks of Epidural Injections?
Epidural steroid injections are known to be safe alternatives to oral painkillers or surgery. You can move easily after getting steroid injections and enjoy a normal lifestyle. However, understanding epidural for back pain pros and cons can help you decide if it’s the right treatment for your condition.
Benefits:
- Quick pain relief
- Reduces inflammation around irritated nerves
- Helps improve mobility and functionality
- Minimally invasive as compared to surgery
- Can delay or avoid surgery
- Mainly used with physical therapy treatment
- Less duration of procedure (usually under 30 minutes)
Drawbacks:
- Temporary relief (weeks to a few months)
- Not a cure for the root cause
- Multiple injections might be needed
- Risk of side effects (headache, dizziness)
- May not be effective for everyone
- Hormonal side effects due to potent steroids
What are the Side Effects of Epidural Injection for Back Pain?
These injections are generally safe; however, some common epidural injection side effects are:
- Mild dizziness or headache
- Low blood pressure
- Shivering
- Allergic reaction
- Seizures
- Infection
- Visual disturbance
- Spinal cord injury
- Leakage of cerebrospinal fluid (rare)
- Nerve damage
What to Expect After the Injection?
You should usually be able to move and work after the injection. Don’t do any intensive activities or drink alcohol for 24 hours.
- You may feel numbness or heaviness in your legs, which will resolve in a few hours.
- There may be some tenderness at the injection site; ice packs can be used for relief.
- Pain after epidural injection is usually mild and temporary, often resolving within a few days.
- Pain relief is gradual and may begin in 1 to 3 days.
Is an Epidural Injection Right for You?
Back pain and epidural injections often go hand in hand as a non-surgical option for lasting relief. But these are not for everyone.
They’re usually recommended when:
- You have chronic back or leg pain (like sciatica).
- Other treatments like meds or physiotherapy haven’t worked.
- Your MRI or scan shows nerve inflammation or compression.
- You want to delay or avoid surgery.
But they may not be right for you if:
- You have bleeding disorders or infections.
- You’re pregnant or allergic to steroids.
- You’ve had multiple injections recently.
FAQs About Epidural Injection for Back Pain
Does steroid block pain?
Instead of blocking pain, steroid coats irritated nerves, reducing inflammation and pain.
Why is no one allowed in the room during the epidural?
Because it is a sterile procedure that requires adequate precision. Your family members may be asked to leave the room until the drug is successfully administered.
Why do epidurals fail?
An epidural failure may occur due to the negligence of the provider and human errors, including incorrect placement, changing the spot after first placement and inadequate dosage of the drug.
Are epidurals 100% effective?
Epidurals are mostly safe and effective, but their effectiveness depends on your condition.
In chronic back pain conditions like radiculopathy or herniation, epidurals have proven to be effective in providing short-term pain relief in 50%-80% of patients. However, long-term relief is less conclusive.
Who cannot get an epidural?
Epidurals are contraindicated if:
- You have an active infection
- You have had a previous spinal surgery
- You are overweight
- Have defective blood clotting
Expert Led, Image Guided Injections
Epidural injection for back pain requires accuracy for successful administration. To avoid any mishaps or epidural failure, expert-led intervention is needed.
Dr. Yasser Mehrez, a leading pain-management consultant in the UK, offers safe and effective delivery of epidural injections.
