Back pain can originate in any of the structures that make up the spine. It is primarily the result of the compression of associated nerve roots and a lack of space from compressive pathology, which can result in conditions such as a herniated disc, bone spurs, arthritic overgrowth, or fat overgrowth in the epidural space.
For patients with spinal nerve pain that is acute and severe or persistent, despite trialing basic treatments like medications and stretches, epidural steroid injections can be considered, as they often provide significant relief. At Prospect Spine and Pain (PSP) in Newark, New Jersey, Dr. Maria Cabodevilla-Conn will identify the root cause of your discomfort and create an individualized treatment plan to improve function and restore quality of life.
Our spines are composed of several complex structures that work together seamlessly when healthy. These include:
Spinal nerves can be compressed from structures within the spine or outside of it, and this compression causes inflammation. As a result, patients can experience pain or uncomfortable sensations of numbness or tingling in the cervical (upper), thoracic (middle), or lumbar (lower) back, as well as the arms or legs. Several conditions may cause this type of pain, including:
As a board-certified and fellowship-trained physiatrist, Dr. Maria Cabodevilla-Conn will determine the source of your pain and whether epidural steroid injections could be an appropriate treatment as part of a multimodal care plan. These injections are often recommended for individuals who experience acute, subacute and even chronic pain. They are used to reduce inflammation allowing the nerve to initiate a healing process and provide pain relief and improved function. This, in combination with recommended exercises and potentially medications, can help avoid unnecessary more invasive procedures and surgery in some patients.
Epidural steroid injections utilize a combination of corticosteroids, which are powerful anti-inflammatory drugs, and anesthetic. When injected into the epidural space, this combination helps reduce inflammation, open the affected area, and relieve pressure to eliminate pain. Accordingly, it’s important to target the injection to the precise location of the affected nerve.
To accomplish this, Dr. Maria Cabodevilla-Conn utilizes fluoroscopic guidance. This allows for real-time X-ray images to guide the doctor to have the most accurate placement of the medication and thus optimal results.
Prior to any injection, Dr. Maria Cabodevilla-Conn will have performed a thorough physical examination, reviewed medical imaging with you, and discussed your medical history and symptoms profile to confirm if this treatment is right for you. While epidural injections are considered conservative treatment and an extremely safe and often effective procedure, it is not recommended for everyone. This is why having an evaluation and discussion with the doctor is invaluable.
An epidural steroid injection is a relatively quick and straightforward outpatient procedure. You are not usually required to have a driver to take you home if the injection is done with local anesthetic only, but some patients prefer this. On the day of your procedure, you’ll receive a local anesthetic to minimize any discomfort. It is recommended to take it easy the day of the procedure and to avoid heavy lifting, strenuous exercise, and physical therapy for one week. In most cases, pain relief begins within five to seven days of the injection but may take up to two weeks for the full effect. Occasionally, people report some increased pain initially (once the anesthetic from the procedure has worn off), but as the medication gets absorbed, this symptom should reduce.
How long the injection remains effective depends on several factors. The doctor will discuss what you personally can do to help prolong the effects of the injection. Patients with recent disc herniations often experience permanent relief. For those with recurrent herniations, chronic pain, or more complex conditions, epidural steroid injections can be repeated or tweaked as recommended by your physiatrist.
To learn more about epidural steroid injections and other pain management treatments at Prospect Spine and Pain (PSP), request a consultation with Dr. Maria Cabodevilla-Conn today.