Lumbar epidural steroid injection complications

Lumbar Epidural Steroid Injections involve injecting a combination of steroid (anti-inflammatory medication) and local anesthetic (numbing medication) around a nerve root or roots (spinal nerve or nerves). This procedure is typically used to treat lumbar radicular pain, commonly referred to as sciatica which is characterized by pain involving the leg(s) with or without low back pain. The goal is to treat inflammation around the nerves in order to provide pain relief and improve function. This procedure is performed using fluoroscopy (a type of X-ray) to guide the placement of the injection.

High dosages of oral corticosteroids taken daily for prolonged periods of time can have serious systemic side effects including bone loss ( osteoporosis), increased risk of infections and diabetes and cataracts, thinning of skin, stretch marks, increased facial/body hair growth, acne, fluid retention, weight gain with redistribution of fat (fat deposits on back and face, thinning of limbs), muscle weakness, decreased resistance to infections, stomach ulcers, mood swings, insomnia, suppression of the body's own production of cortisol, etc.

The physician places a small needle through the skin of the lower back and through a natural opening in the bones of the spine. The needle then is directed into the epidural space where spinal nerves travel. A small amount of x-ray dye shows the doctor that the needle is in the correct location. The injection includes a mixture of medications that reduce inflammation and medications that reduce pain. Epidural injections can be performed in the neck, upper back or low back. They can be placed in the middle of the spine, between the back of the vertebrae. This is an interlaminar injection. Epidural injections can also be performed at the exit point where the nerves leave the spine, the foramina. This is a foraminal injection.

If an epidural is recommended then the patient will likely undergo an MRI (magnetic resonance imaging) scan prior to treatment so as to ascertain the exact location of the troubled nerves. Epidurals are mostly conducted at outpatient clinics, or at the patient’s local surgery. Only qualified health professionals can administer the injections, such as anesthesiologists, radiologists, neurologists, and surgeons. Medical centers often have specific pain management clinicians who conduct epidurals and can advise on other methods to relieve neck pain from trauma such as whiplash , spinal stenosis, and arthritis.

Corticosteroid side effects may cause weight gain, water retention, flushing (hot flashes), mood swings or insomnia, and elevated blood sugar levels in people with diabetes. Any numbness or mild muscle weakness usually resolves within 8 hours in the affected arm or leg (similar to the facial numbness experienced after dental work). Patients who are being treated for chronic conditions (., heart disease, diabetes, rheumatoid arthritis) or those who cannot temporarily discontinue anti-clotting medications should consult their personal physician for a risk assessment.

Lumbar epidural steroid injection complications

lumbar epidural steroid injection complications

If an epidural is recommended then the patient will likely undergo an MRI (magnetic resonance imaging) scan prior to treatment so as to ascertain the exact location of the troubled nerves. Epidurals are mostly conducted at outpatient clinics, or at the patient’s local surgery. Only qualified health professionals can administer the injections, such as anesthesiologists, radiologists, neurologists, and surgeons. Medical centers often have specific pain management clinicians who conduct epidurals and can advise on other methods to relieve neck pain from trauma such as whiplash , spinal stenosis, and arthritis.

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