Epidural steroid injections are most commonly used in situations of radicular pain, which is a radiating pain that is transmitted away from the spine by an irritated spinal nerve. Irritation of a spinal nerve in the low back ( lumbar radiculopathy ), such as from lumbar spinal stenosis , cervical spinal stenosis, herniated disc , and foraminal encroachment, causes back pain that goes down the leg. Epidural injection is also used as a minimally invasive procedure to treat nerve compression in the neck (cervical spine), referred to as cervical radiculopathy , which causes pain.
Epidural injections are often used to treat radicular pain, also called sciatica , which is pain that radiates from the site of a pinched nerve in the low back to the area of the body aligned with that nerve, such as the back of the leg or into the foot. Inflammatory chemicals (. substance P, PLA2, arachidonic acid, TNF-α, IL-1, and prostaglandin E2) and immunologic mediators can generate pain and are associated with common back problems such as lumbar disc herniation or facet joint arthritis . These conditions, as well as many others, provoke inflammation that in turn can cause significant nerve root irritation and swelling.
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.