Epidural Steroid Injections

Epidural Steroid Injections

Epidural Steroid Injections

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Should you get Epidural Steroid Injections?      It depends on the rationale for the treatment.  In my practice,  I use Epidural Steroid Injections for both treatment as well as diagnostic purposes.  The research for these injections have been significant, but the conclusions by the various authors have been very different.  If you must know,  there is controversy on the efficacy of the treatments.  Traditionally,  epidural steroid injections have been seen as a reasonable treatment option for patients with back pain and sciatica. But, now in the era of “cost effective” medical care,  the clinical benefits are measured against its costs to the system.  And,  as we know from the recent experience of contamination of the medications,  measured against the risks associated with epidural steroid injections.  A simple search of the internet will reveal many articles on the risks and benefits of the procedure.  Based on my experience,  epidural steroid injections definitely have a role in the treatment of patients with back pain and sciatica.

In theory,  epidural steroid injections benefit the patient by delivering corticosteroids to the areas of inflammation.  The steroids have a known anti-inflammatory effect, and will decrease the swelling to the tissues upon contact.  In a very simplistic way,  by decreasing the swelling,  the affected nerves in the spine will no longer have as much irritation.

Some practitioners also inject a volume of saline associated with the steroids,  and theorize that the volume of saline also flushes the area of painful chemicals that also lead to the inflammation.

In my practice,  I use epidural steroid injections when a patient has a sciatic, or nerve inflammatory complaint.  I believe the epidural steroid injections can help decrease the inflammation, and therefore reduce the pain.

For diagnostic purposes,  if the epidural steroid injections give even temporary relief,  it usually confirms that there is an irritant to certain nerves.  Based on temporary improvement, surgeons may consider the patient an appropriate candidate for surgery, as many practitioners use the so called transforaminal technique to try to isolate the specific nerve that may be causing the irritation.

There are certainly risks to the procedure, but in general,  epidural steroid injections can provide pain relief for certain patients, and can help isolate the cause of the spine pain.  Please discuss the details of the procedure with your physician.

Citations

  • Epstein NE. The risks of epidural and transforaminal steroid injections in the Spine: Commentary and a comprehensive review of the literature. Surg Neurol Int. 2013;4(Suppl 2):S74-93. PubMed PMID: 23646278

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Author and Contributor to www.Spine-Health.com – July, 2015

www.Spine-Health.com/author/john-h-shim-md-facs

Chief of Surgery, Mease Countryside and Mease Dunedin Hospitals, Safety Harbor and Dunedin, Florida. 2014-2016.

Orthopaedic Section Chief Mease Countryside Hospital; Safety Harbor, Florida Mease Dunedin Hospital; Dunedin, Florida.2008-2013

Board Member Morton Plant Mease Research Council

Co-Director of Mease Neuro-Ortho Spine Center Mease Dunedin Hospital; Dunedin, Florida.

One of “6 Spine Physicians Ranked #1 on Google” – December 2016

Top Ten Most Liked Spine Surgeons on the Internet – July 2016

2016 Spine Surgeons to Know list – January 2016

2014 Spine Specialists to know list – September 2014

One of Ten Leaders of Certified Spine Programs – December 2011

 

The Best Orthopedics in Tampa

The information provided on this website does not provide or should be considered medical advice. It is not a substitute for diagnosis or treatment of any condition. The information provided is for informational purposes only. You should not rely solely on the information provided on this website in making a decision to pursue a specific treatment or advice. You should consult directly with a professional healthcare provider.

As a condition of using the information on this website, ShimSpine and its physicians are not responsible for any advice, diagnosis, treatment or outcome you may obtain.

ShimSpine.com is completely self-funded. No outside funds are accepted or used. This website does not utilize paid advertising as a source of revenue.
Outpatient Spine Surgery Considerations. www.Spine-Health.com. January 2016.

What is Spinal Stenosis? www.Spine-Health.com. October 2015.

Surgeon insights on the Changing Landscape of Orthopedic Care. OrthopedicToday. June 2014

Chapter 33: Interspinous Spacers. Shim JH, Mazza JS, Kim DH Published in Minimally Invasive Percutaneous Spinal Techniques. Elsevier Health Sciences, Philadelphia, Pennsylvania. (Published 2011)

Chapter 35: Minimally Invasive Percutaneous Lumbar Fusion Technique.Shim JH, Mazza JS, Kim DH Published in Minimally Invasive Percutaneous Spinal Techniques. Elsevier Health Sciences, Philadelphia, Pennsylvania. (Published 2011)

March 2010 Minimally Invasive Transforaminal Lumbar Interbody Fusion American Academy of Orthopaedic Surgeons Annual Meeting New Orleans, Louisiana February 2010

February 2010 A Review of Dynamic Stabilization in the Lumbar Spine Selby Spine Symposium; Park City, Utah

November 2009 Lumbar Spinal Stenosis Community Based Lecture; Tampa, Florida

September 2009 Instructor/Proctor Minimally Invasive Lumbar Cadaver Lab; Tampa, Florida

February 2009 New Spinal Technology: Cervical Disc Replacement and Interspinous Spacers. Selby Spine Symposium; Park City, Utah

February 2008 The Degenerative Spine: The Role of Dynamic Lumbar Stablization and Interspinous Spacers Selby Spine Symposium; Park City, Utah

October 2008 Emerging Technology and Techniques in Spinal Surgery Orthopaedics in the 21st Century Symposium; Morton Plant Mease Healthcare; Largo, Florida

September 2007 Emerging Technology in Spinal Surgery Orthopaedics in the 21st Century Symposium; Morton Plant Mease Healthcare; Largo, Florida

October 2006 Emerging Technology and Techniques in Spinal Surgery Orthopaedics in the 21st Century Symposium; Morton Plant Mease Healthcare; Largo, Florida

May 2005 The Role of Kyphoplasty in the Treatment of Vertebral Compression Fractures Mease Neurosciences Symposium; Clearwater, Florida
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