As mentioned above, there may be more than one spinal structure causing your spine pain. Sometimes, there are multiple causes for your spine pain or radiculopathy. In this case, Dr. Lee may recommend alternative treatment options or steriod injections. For example, if your sciatica/leg pain or hand pain improves with epidural steroid injection but you still have low back pain or neck pain, you may benefit from facet joint injections. But, whatever the case, you will need further evaluation by Dr. Lee to decide on further treatment. Remember that there are multiple treatments available now for pain and just because one method yielded partial or no response DOES NOT necessarily mean you will “just have to live with the pain”!
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.
An epidural steroid injection places this powerful anti-inflammatory medication directly around the spinal nerves. Traditionally epidural injections were administered without any special equipment, by inserting the needle by feel in the area around the spinal nerves. More recently epidural injections have been administered with the aid of imaging tools to allow your physician to see the needle going to the proper location. Either real-time x-ray called fluoroscopy, or CT scan can be used to 'watch' the needle deliver the medication to the proper location.