Epidural Steroid Injections are used as treatment for disc bulges and herniations that cause compression and inflammation of nerve roots. Compression may also be caused by a narrowing of the bones opening around the nerve (Neuroforaminal Stenosis) or a narrowing of the spinal canal (Spinal Stenosis).
This may cause pain in that particular area of herniation or at a distant location where that spinal nerve supply innervation.
The specific location and degree of the bulge/herniation determine where the injections are placed, how many are needed and whether other interventional therapies are needed.
In addition disc tears may release nerve-irritating enzymes.
Symptoms of Disc Bulge/Herniation:
A) Lumbar (Lower Back):
B) Cervical region (Neck):
C) Thoracic region (Mid Back):
Epidural Steroid Injectionsplace steroid medications in a precise location around the nerve relieving pain by reducing inflammation.
These injections are performed with IV sedation and out patient basis.
The number of injections depend of many factors including but not limited to location and extend of the pain, how many areas are involved and how long the pain has been present.
A series of Three (03) injections may be necessary for maximum of effectiveness as they will “build on each other” and provide long term relief.
This treatment may the future need for surgery with the best results achieved when diagnosed early and treated promptly.
During the Injection
The patient lies on a special table and after appropriate intravenous sedation is administered, the skin and deeper tissues are numbed up with a dentist needle and local anesthetic. Then a needle is advanced under X-ray Guidance (Fluoroscopy) til reaches the epidural space in the vicinity of the nerve. Dye contrast is then injected to confirm proper placement in the exact area of the nerve inflamed and a steroid medication is injected which act as a potent anti-inflammatory medication. This will result in resolution of the inflammation and swelling of the nerve.
After the Injection
The patient is observed for about half hour in the recovery room, monitoring the vital signs and then is discharged home. Dr. Sammarone recommends that If you have soreness or discomfort at the injection site, you can place a cold pack over the site for fifteen minutes every two hours for the first twelve hours. Then, after 24 hours it is recommended to use a heating pad or taking a hot shower and allowing the water to be directed to sore area.
Marcello Sammarone, M.D.
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