BACK AND NECK PAIN
Eight out of ten people will suffer from back pain at some time in their lives. For some, back pain may happen suddenly – a wrong twist or turn. For others, it may develop gradually, growing from occasional spasms into a chronic and disabling, painful condition.
Most back pain is caused by problems with muscles and ligaments, but a certain percentage is caused by “slipped discs.” Discs are the cushions which separate the vertebrae (the bones of the spinal column). With a “slipped disc”, a portion of the disc protrudes into the canal containing the spinal nerves. This causes pressure and irritation to the nerve. Since these nerves run to the leg and foot, the slipped disc can cause sciatica-pain and/ or numbness in the leg. Back and leg pain can also be caused by fractures, arthritis and degenerative changes of the spine, and slippage of one vertebra on another.
EPIDURAL STEROID INJECTIONS
Surgery is not always a necessary treatment for most slipped discs. The Initial treatment of choice includes rest, medication, physical therapy and exercise. Epidural steroid injections are a practical, safe and effective method of treating back pain problems caused by nerve compression. The injections work by reducing the swelling and inflammation around the discs and nerves. The injection DOES NOT merely cover up the pain. When swelling and inflammation are reduced, the pressure on the nerve is reduced. This produces pain relief and a reduction of other symptoms.
An epidural steroid injection consists of a steroid and sometimes a small amount of local anesthetic. This is injected into the sleeve (epidural space) surrounding the spinal area. It is not a spinal injection. The local anesthetic sometimes produces a temporary pain relief of several hours. After this wears off, much like in the dental office, the original pain may return at the same intensity or at an increased level for 24 to 36 hours. At that time the steroid begins to work. You may then start to feel further pain relief. Additional injections may be necessary before any improvement is felt. The injection can be performed once or in a series of 3, spaced 1 to 2 weeks apart.
At home after the injection, you may return to your usual moderate activities. If your referring physician advises you to stay in bed, then follow these instructions; otherwise you may be up and active. Listen to your body. It will tell you how active or inactive to be. Continue to take your regular medications.
Moist heat can be used if you experience back soreness or stiffness after the Injection. Soak in a hot bath or stand in a hot shower with a towel wrapped around the painful area. For some people, cold is more effective than heat. An ice pack can be applied to the sore area. Do not use Ice for any longer than 10 minutes at a time. Either heat or cold may offer pain relief. We suggest you use the one that feels best to you.
In addition to the application of heat or cold, many people find a change of resting position helpful in reducing both soreness and stiffness.
If you begin to feel much better several days after the injection, we caution you not to push yourself. Slowly increase activity, allowing time for your muscles to rehabilitate. Epidural steroid injections should not be considered the sole method for treatment of back pain. Rest, medication and physical therapy are very important. A rehabilitative exercise and activity program is necessary for increasing strength, endurance and flexibility. Learning proper posture, bending and lifting techniques is critical.
Complications of epidural steroid injections are infrequent and include infection, bleeding, spinal tap and temporary drop in blood pressure.
1012 Druid Road East
Clearwater, Florida 33756
Jasmine Lamb, M.D.
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