When to Consider an Epidural Injection for Back or Neck Pain

When you have chronic back or neck pain, simple tasks like driving,  desk work, and even sleeping, can feel torturous.

If conservative treatments, such as physical therapy or over-the-counter pain relievers, have failed to alleviate your chronic back or neck pain, consider an epidural steroid injection.

At Georgia Pain Management in Woodstock, Georgia, board-certified interventional pain management expert James Ellner, MD, specializes in nonsurgical pain relief, including epidural steroid injections.

Here’s what he wants you to know about this often life-changing treatment.

The role of nerves in back and neck pain

Your spine is an intricate network of bones, joints, discs, ligaments, and muscles that provide structural support for the body. It also houses and protects the spinal cord, which is the main highway of your central nervous system.

Highly sensitive nerve roots branch off from the spinal cord at points along the spine, most often threading through tiny openings called foramina. These nerves carry sensory (sensory) and motor (motor) information to and from the arms, legs, and other parts of the body.

When a disc bulges, arthritis develops, or inflammation sets in, the nearby nerves can become compressed and painful. Back or neck pain related to muscular tension or strain tends to remain localized. However, nerve-related pain may radiate (travel) to other areas.

How an epidural injection can alleviate back and neck pain

An epidural steroid injection is an in-office procedure that takes 15-30 minutes. After applying a local anesthetic to numb your skin, Dr. Ellner uses fluoroscopy (real-time X-ray guidance) to guide the needle into the targeted epidural space.

An epidural steroid injection contains a potent anti-inflammatory (such as dexamethasone or methylprednisolone) that precisely targets inflammation irritating the affected nerves.

Reducing inflammation helps ease pressure on the nerves and relieves pain. Results typically occur within a few days, and pain relief may last for weeks to months.

Research shows epidural injections provide 40% to 84% for patients with neck pain, and 50% to 80% from those with back pain. Relief often lasts weeks to months. They are best for radiating pain (radiculopathy) rather than general back pain.

Most patients can go home shortly afterward. We generally recommend taking it easy for a day or two to allow the corticosteroid to take effect. Full results may take several days to a week.

When to consider an epidural steroid injection

Dr. Ellner may recommend an epidural steroid injection if:

• You have neck or back pain lasting more than a few weeks
• You have pain radiating into your arms or legs, suggesting nerve involvement
• Physical therapy, medication, and other conservative treatments haven’t provided relief
• Pain interferes with your daily routine
• You’re unable to rest or participate in rehab due to pain

An epidural steroid injection can also help reduce inflammation and nerve irritation after back surgery. Because the space surrounding spinal nerves is minimal, even small changes, such as a vertebral bone spur (osteophyte), can press on and inflame nearby nerves.

If you’re suffering from neck or back pain, Dr. Ellner can help. Contact the office to request an appointment today.