Epidural Steroid Injections

Many patients have heard about epidural injections (commonly known as epidurals) because they, their friends, or their spouses have had epidurals for labor delivery. Epidurals are currently the standard pain management for labor delivery in the U.S. and most developed countries.

So what are epidurals?

The human spinal cord is an organ controlling sensation, movement, vascular construction, sweating, and hormone production. Similar to the brain, the spinal cord is well protected with spinal fluid, which is contained by a few layers of membranes. The outside layer of the membranes is the thickest and strongest layer, named dura. In the spinal canal, there is a loose space between the dura and surrounding bone structures called the epidural space, where spinal nerve roots exit the spinal cord and spinal canal to reach every part of the body. Epidural injections mean delivery of medications to the epidural space.

Epidural steroid injections are used to reduce inflammatory response of the spinal nerves or discs, caused by a variety of reasons. Selective nerve blocks are also called transforaminal epidural steroid injections. The medications are selectively delivered to particular spinal nerve roots through neuroforamina, which are canals that the spinal nerves use to exit the spinal column. If the pain is relieved by selective nerve blocks, it suggests the pain generators are related to inflammation in those particular nerve roots. Therefore selective nerve blocks are not only therapeutic but are frequently used for diagnostic purposes.

Epidural steroid injections are very simple and safe procedures. They are done under x-ray guidance and with light sedation. Patients are normally released after 1-2 hours and can return to their normal work and activities the next day if sedation is used.