What is an Epidural, and What Does it Do?
Back pain can be extremely disruptive to a person’s life. While the occasional aching back is easy enough to power through, chronic back pain from conditions like herniated discs, sciatica, and spinal stenosis, can be debilitating. Even the simplest tasks of every day life can feel overwhelming, and the pain can seem never ending. Fortunately, there are effective treatments to alleviate back pain and offer a new lease on life. One such treatment is epidural injections (ESI), which offer temporary relief and help alleviate pain so that the person with back pain can be proactive about working on the underlying issue.
How Long Does an ESI Last?
Many people are only familiar with the term “epidural” in the context of childbirth, and that kind of epidural only lasts for the duration of labor. Epidural steroid injections for back pain are a different kind of treatment, containing a mixture of medications, and the different medications can impact how long relief lasts. Typically, there is an anesthetic in the injection, and this provides immediate pain relief. After a few days, the steroid begins to take effect, and this can last for anywhere from a week to a year. In some cases, it is recommended for patients to have three repeat injections, two weeks apart, and then wait six months to a year for another series of injections.
Back Pain and Epidural Injections: How Quickly Does the Pain Ease?
The reason people get epidural injections is because they provide quick relief from back pain. Imagine the relief of having pain alleviated when you have been suffering through it for months! An EPI will take full effect in about two weeks, but most people report experiencing less back pain after just a few days. Upon receiving the epidural, there is immediate relief from pain because of the anesthetic. However, the pain is likely to increase for a day or two once the anesthetic wears off. However, the purpose of the steroids in the injection is to reduce inflammation and swelling, and once that begins to happen, the pain will be significantly less than it was before the ESI.
How Does an ESI Work? What Epidural Side Effects Should I Expect?
To understand how an ESI works, it helps to have some knowledge of spinal anatomy. The spinal cord is a tube of nervous tissue, and it runs from the base of the brain down to the lower back. The spine is the framework of bones, joints, and discs that protect the spinal cord, because the spinal cord is delicate yet important, responsible for carrying messages between your brain and other parts of your body. The spinal cord is also protected by the spinal meninges, specialized membranes that envelop the spinal cord and separate it from the surrounding structures. The epidural space is between the spinal cord and the meninges, and it contains fat, loosely packed connective tissue, and spinal nerve roots. It acts as a cushion for the spinal cord and nerves, and it is an ideal place for injections, because it allows medication to directly yet safely reach the nerve roots. An ESI delivers steroids, along with some additional medications like local anesthetic, into the epidural space. The injection is administered with fluoroscopic guidance and contrast-enhanced imaging, so that the doctor can ensure that the medicine reaches the correct spot. This procedure is safe and effective, with very few risks. There may be some pain at the injection site, or some temporary side effects from the steroid, like hot flushing, temporary weight gain, and a temporary increase in blood sugar. Rarely, an inadvertent puncture of the meninges can lead to a leak of spinal fluid, and this may necessitate an epidural blood patch.
How Long Does an Epidural for Back Pain Last?
The relief an epidural for back pain offers can last for up to a year. The efficacy of the injection depends on the type of steroid used, whether the needle is positioned correctly, and how much rest the patient gets after the injection. It is important to rest after this type of injection, so that the steroid will remain in the area it is supposed to treat, rather than being absorbed into the bloodstream and carried to other parts of the body. However, most people are back to their regular activity level after a few days. The location and severity of the pain also comes into play in terms of how long the relief lasts. The most significant benefit of an epidural is that it is a non-invasive procedure and may eliminate the need for back surgery. Studies of epidurals for back pain indicate that pain was reduced by 83 percent and sleep quality improved by 69 percent, after just two weeks. Epidurals can also reduce the symptoms of pain-related depression and improve flexibility when bending towards the floor.
What if I Still Have Back Pain After an Epidural?
Epidural injections are highly effective in about 80 percent of cases. One beneficial strategy is to engage in physical therapy while the epidural is working, so that when it begins to wear off, the back is strengthened and there may not be further need for treatment. Working with a pain management specialist, you can come up with a customized plan to relieve your pain and improve your quality of life. If the epidural injection doesn’t work, there are other treatment options available for effective pain relief. Radiofrequency ablation, for example, is a minimally-invasive procedure that can disrupt pain signals to the brain.
For a Comprehensive Strategy for Pain Relief, Contact Greater Maryland Pain Management
At Greater Maryland Pain Management, we’re committed to helping you overcome the pain that keeps you from living life to the fullest. As the field of medicine continues to evolve, our team strives to bring our patients the most effective, innovative, non-invasive treatments, to help them overcome life-limiting pain. Our practice was founded by Jank Vidyarthi, MD, a board-certified, award-winning Interventional Pain Management physician who has helped thousands of people to overcome chronic pain. We pride ourselves in treating each patient with the care and compassion we’d show our own loved ones, helping them to improve their quality of life through a customized approach that addresses the patient’s unique needs. We have multiple locations and schedule appointments quickly, sometimes even the same day, so contact us for a consultation.