This study only looked at patients with pain from disc herniations not any of the many other spinal problems injections are used for. In a recent study comparing injection of local anesthetic with combined analgesic and steroid, researchers found that epidural injections (more commonly known as epidural steroid injections or ESI) were superior to analgesic injections alone. Each of these three types of ESI injections has advantages. ![]() The injection can be performed by placing the needle in one of three of these openings (caudal, interlaminar, transforaminal). There are several openings in the bones that surround the epidural space where a needle can be placed. Or it could be one of those two numbing agents combined with a steroid (antiinflammatory medication). The injection solution can be a local anesthetic like lidocaine or bupivacaine. There are two different types of injections and three locations to give them. In some cases, the reduced pain makes it possible for the patient to participate in a physical therapy program, become more active, and be better able to control the symptoms with a conservative program. They do not cure any of the diseases they are commonly used for, but can control the symptoms for prolonged periods of time. These injections control pain by reducing inflammation and swelling. Fluid such as the lidocaine and cortisone that can be injected is free to flow up and down the spine and inside the epidural space to coat the nerves that run inside the spinal canal. ![]() The epidural space is normally filled with fat and blood vessels. The dura is the sac that encloses the spinal fluid and nerves of the spine. This space is the area between the bony ring of the spine and the covering of the spine called the dura. When doing an epidural injection, the doctor inserts a needle through the skin so that the tip of the needle is in the epidural space. ![]() But this treatment has also been used in patients with spinal stenosis, postlumbar surgical syndrome, failed back syndrome, and other mechanical causes of low back pain. Epidural injections are a common way to treat painful back problems, especially problems caused by degenerated or herniated discs.
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