Lumbar herniated disc treatment sometimes involves the use of epidural steroid injections (ESI). Epidural steroid injections are a nonsurgical treatment option used for neck and back pain relief and a common treatment of pinched nerve pain.
The procedure involves the injection of an anesthetic medication (such as Lidocaine or Marcane) and a steroid (usually DepoMedrol) into the epidural space of the spinal column. The purpose of the procedure is to create a local anti-inflammatory effect to shrink swollen nerve tissue and reduce pain.
Epidural steroid injections are used for both therapeutic and diagnostic purposes. Usually a series of 3 to 4 injections are prescribed over a 4 to 6 week time period. The patent’s response to the injections will typically be a determining factor for what future treatment may be required (i.e. surgery).
For an ESI series to be most effective, each injection should be scheduled between 7 and 10 days apart. The reason is because the maximum benefit for the steroid medication is about 48 hours, with the medication being completely depleted in the system by 7 days. Therefore, epidural steroid injections scheduled beyond 2 weeks apart are MUCH less effective.
ESIs are only effective if the actual irritation is centrally located – i.e. within the spine – as opposed to peripheral (outside the spine). An example of a peripheral problem would be a piriformis muscle syndrome for which ESIs would be of little benefit.
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