Lumbar Epidural Steroid Injections for Low Back Pain and SciaticaFor those of you who are just joining us, allow me to share my opinion of cortisone injections as a treatment codtisone back pain and sciatica. Cortisone injection, epidural, steroid injection, and epidural steroid injection kow all essentially the same thing. The goal is to pajn a chemical into the inflamed area and try to methenolone enanthate structure the inflammation, delivering relief in the short term. How testosterone xl review it that professional athletes can play hurt or beat themselves up on game day, and a week later they can do it again — and continue to do this cortisone shots low back pain after week, year cortisone shots low back pain year? The answer is simple: Science has learned how to trick the body into feeling better and working harder. Sure, steroid injections can reduce localized inflammation, and that can help you feel better.
Lumbar Epidural Steroid Injections for Low Back Pain and Sciatica
The discs of the spine are located between the vertebrae bony building blocks of the spine. The disc is designed somewhat like a jelly donut being composed of an inner gelatin-like core the nucleus pulposus surrounded by a firm outer ring the annulus fibrosus. When the disc structure wears, because of processes such as aging or trauma , it becomes weakened and susceptible to injury.
In this condition, stresses on the spine can cause the inner core to protrude outward through the boundary of the disc's outer ring. The is referred to as herniation of the disc. When the disc herniation is in the spine of the lower back, it can cause a radiating pain down the legs, commonly referred to as sciatica.
Picture of a herniated lumbar disc. A majority of patients with sciatica from disc herniation have resolution of their pain with various conservative measures, including anti-inflammatory and muscle-relaxant medications, exercises, physical therapy, and time. In recent decades, cortisone medications have been injected into the space around the spinal cord epidural space to reduce the inflammation and swelling of the disc herniation, thereby relieving irritation of the adjacent nerves.
It has never been certain as to whether this procedure epidural injection can actually reduce the need for surgery. A study by Simon Carette, MD, and others from Laval University and the University of Montreal, looking at the long-term benefits of epidural injection for sciatica from disc herniation, was published in the New England Journal of Medicine ; Carette's study found that although epidural injections for disc herniation of the low back relieved pain in the leg temporarily, the benefit was short-lived.
In fact, after three months, there was no benefit from epidural injection compared to saltwater placebo injection.
Further, the need for surgery was not influenced by the injection even one year later. Carette's study demonstrated that epidural cortisone injections can relieve pain in the short-term. However, this study seems to suggest that undergoing an epidural cortisone injection for sciatica from a herniated disc in order to avoid surgery may not be valid. Medically reviewed by Aimee V.
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