How often can you get epidural injections for back pain

We all want pain-free days, which can be rare for some neck and back pain sufferers, who may even have radiating pain into the arms and legs. If this describes you, and other treatments aren’t providing the relief you need, you may be a candidate for epidural steroid injections. The procedure involves injecting medications into the epidural space, where they can reduce inflammation and pain.

Dr. Phillip Lim here at the NuVation Pain Group is an expert in interventional pain medicine and pain management and can determine if epidural steroid injections are the right course of action for you.

When to consider an epidural steroid injection

Most of the time Dr. Lim starts with more conservative, less invasive treatments with the goal of decreasing or eliminating your pain and increasing function in the affected areas. He may recommend physical therapy to provide stretching and strengthening exercises or oral pain medication.

Epidural steroid injections typically contain a local anesthetic and a steroid. You get quick pain relief from the anesthetic. The steroids can reduce inflammation, which opens up the nerve passages, takes pressure off the nerves, and provides pain relief. If you’re experiencing any of the following conditions, you may benefit from an epidural steroid injection:

• Inflamed spinal nerves
• Spinal stenosis
• Herniated disc
• Slipped disc or vertebrae

The injection is given under a type of X-ray guidance called fluoroscopy to direct the medications to the precise locations you need it. The anesthetic provides immediate, but temporary, pain relief. The steroids will normally start working within 1-3 days, but could take as long as a week to kick in.

Usually you can return to your daily routine the next day. You’ll keep in touch with Dr. Lim so he can monitor your progress.

Limiting epidural steroid injections

There are, of course, pros and cons to this treatment. Dr. Lim discuss them with you, along with the known, potential side effects, so that everything is clear.

While the results can be very helpful and make a huge difference in the level of your pain, you can have only a limited number of epidural steroid injections in a year. That’s because the injections, while helpful for your pain, can cause some unwanted symptoms.

Potential side effects from epidural steroid injections include:

Weakened spinal bones and muscles

• Thinning of skin or a loss of skin color
• Facial flushing
• Sleep issues and disruption
• Moodiness
• Disruption in the body’s natural hormone balance

Your best bet is to come in and see Dr. Lim and discuss the risks versus benefits, as well as the other cutting-edge options we have for treating your pain. Call one of our offices in Buena Park or Los Angeles, or you can make an appointment online with the convenient booking tool. Don’t live with pain. Let us help you get relief.

Epidural steroid injections, or ESI, are indicated for many forms of low back pain and leg pain. The goal of this treatment is pain control. Epidural injection tends to provide temporary relief from pain, and the effects could last from one week up to one year. It is especially beneficial for a patient suffering from acute back and/or leg pain. It often provides sufficient pain relief to allow for rehabilitative stretching exercises.

Epidural injections in the low back area used to treat low back pain and radicular pain (also referred to as leg pain or sciatica) but could be used for cervical (neck) pain as well. Patients who have “radicular” symptoms (such as sciatica) respond better to the injections than those who have only back pain.

How Long Does An ESI Last

It is difficult to say how long their effect will last. Generally, the immediate pain relief is from the local anesthetic injected, but this wears off in a few hours. The steroid starts kicking in between 2 to 7 days and its effect, as mentioned above, can last for several days up to a year. One can have up to three repeat injections, each two weeks apart. This should lead to a gradual but incremental improvement in pain. If there is a need to have more injections, it is advised to wait at least 6 months to a year before more injections can be administered.

Risks Involved with ESI

This procedure has very few risks, except temporary localized pain from the injection. Rarely, there may be a puncture of the “sack” containing spinal fluid, or other rare complications such as infection, bleeding, nerve damage, etc. Side effects of the injected steroid are generally temporary and include hot flushing, temporary weight gain, a short-term increase in blood sugar, etc.

How Does An ESI Work?

An epidural steroid injection delivers steroids directly into the epidural space in the spine. Sometimes additional fluid (local anesthetic and/or a normal saline solution) is used to help ‘flush out’ inflammatory mediators from around the area that may be a source of pain. The drugs used include a steroid as an anti-inflammatory agent. As inflammation is associated with these low back conditions, reducing inflammation tends to help with the pain. Typically used steroids include Triamcinolone acetonide, Dexamethasone, and Methylprednisolone acetate. For local anesthesia, Lidocaine (Xylocaine) is preferred as a fast-acting local anesthetic for temporary pain relief. Bupivacaine may be used a longer lasting alternative. Saline is used to diluting the local anesthetic.

It is important to note that when the injection is properly administered with fluoroscopic guidance and then confirmed through contrast-enhanced imaging, greater than 50% of patients receive some pain relief with these injections. Even if not fully effective, pain relief achieved by injections can improve a patient’s mental health and quality of life, and more importantly, minimize the need for opioid analgesic use, which has addiction potential. It can also potentially delay or in some cases, avoid surgery.

All content has been reviewed and approved by orthopedic specialist Dr. Zvezdomir “Zed” Zamfirov. Dr. Zed’s practice — All Star Pain Management and Regenerative Medicine — proudly serves the Annapolis, Greater Baltimore and Washington D.C. areas. For more, contact Dr. Zed or call 443-808-1808.