When do you need epidural steroid injections?

Only when you. are still in pain from sciatica due to a herniated disc, spinal stenosis or even facet arthropathy after completing a round of conservative care. This typically means you have tried medications, exercise, therapy and no help to your pain has been attained during that time.
Never. Nobody ever "needs" an epidural. It is an elective procedure that is part of the treatment continuum for disc disease of the spine and often a less invasive prelude to possibly surgery as an option. Epidurals typically work best on patients with newer onset symptoms of sciatica or radiculopathy. It is an option, but never a "must do". I say this as an interventional pain specialist.
Failed other options. Epidurals are often used to help relieve pain from an inflammed disc or pinched nerve. These may be used to relieve back pain after a conservative trial of medication, physical therapy, and rest.

Related Questions

What are epidural steroid injections used for?

Inflamed nerves. Epidural steroid injections reduce inflammation of nerve roots often caused by disk herniations in the spine. For the lumbar spine, they are more likely to work when pain radiates down one or both legs. They can give a week to a year of relief. Talk to your doctor about it as there is a lot more to discuss. Good luck. Read more...
Decrease swelling. The steroids in epidural injections are designed to decrease swelling and inflammation around nerve roots, and so decrease pain. Read more...
Back and neck pain. Epidural steroid injections are typically used to treat back pain, neck pain, and radiculopathy associated with bulging or herniated intravertebral cervical, thoracic, and lumbar discs as well as spinal stenosis, post-herpetic neuralgia, and failed back surgery syndrome. Read more...
Spinal Conditions. Many spinal conditions will respond to epidural steroid injection such as sciatica, degenerative disc disease, bulging, protruding, extruded discs which are disturbing spinal neural structures. The body has the inherent ability to cure itself given time. Steroids simply reduce inflammation around the neural structures, reduce pain, in order for time for you body to heal. Read more...
Epidural Pain Relief. Results in decreased Inflammation around the spinal nerve roots and Increased return to activity level as your body is healing from a herniated disk, spinal stenosis or even facet arthropathy. Read more...

What are epidural steroid injections used to treat?

Spine-related pain. There are many indicated uses for these injections. Generally, they are used for radicular pain (that is, arm or leg pain) from a cervical or lumbar disc herniation, arthritis or stenosis. A physician specializing in Pain Medicine or Physiatrist usually administers these injections under X-ray guidance. Read more...
Epidural Pain Relief. Results in decreased Inflammation around the spinal nerve roots and Increased return to activity level as your body is healing from a herniated disk, spinal stenosis or even facet arthropathy. Read more...

When do people generally get epidural steroid injections?

Pain and labor. An epidural is a procedure to gain access to a space that surrounds the nerves and even spinal cord in the spine. The space is then injected with different medications that can range from anesthetics to steroids. For chronic pain management steroids are often used. For labor and acute post op pain anesthetics are often used. Read more...
Failed Treatment. When more conservative treatments such as anti-inflammatories, rest, and physical therapy fail and patients have what is known as radicular symptoms such as sciatica or arm pain thought to be caused by disc disease. Read more...
When there is nerve . Inflammation due to mechanical compression or chemical irritation. It should be an active part of your treatment not a solution when physical therapy fails. Epidurals cure nothing, time and physical therapy do. You should ask for a physical therapy referral immediately after your first injection. Read more...
4-6 weeks. Initially the symptoms last 4-6 weeks and if your body heals like it supposed to then pain relief starts. However disc herniations which are the cause of majority of sciatica symptoms last for 6-9 months and therefore people can have pain during that time as well. If not better after 6 weeks see a spine specialist to evaluate this further. Try core exercise s first, check youtube or see PT. Read more...

What are the common risks of epidural steroid injections?

Rare. In the hands of someone experienced epidural injections are very safe. They are done often under light sedation and utilize x-ray for proper placement. Most common risks are dural puncture leading to a leak of cerebrospinal fluid. This can lead to headaches. Once recognized there are ways to treat this. Other risks are injection site pain, infection and bleeding. Read more...
Epidural complicatio. The general risks of epidural injections (steroids or other wise) are: infection (meningitis, epidural abscess), bleeding, back pain localized to injection site (may last up to 3 weeks), nerve injury and accidental dural puncture causing headaches. Read more...
Like Any Other Inj. The worse part of an epidural injection is typically the local anesthetic administered to numb the skin. After that the needle typically feels like pressure. However as the needle enters the spinal canal or around the nerve root there can be some pain that is transient. Complications can be bleeding, infection, nerve damage and paralysis, but these are extremely rare. Read more...
Minimal. Localized increase in pain. Non-positional headaches resolving within 24 hours. Facial flushing. Anxiety. Sleeplessness. Fever the night of injection. High blood sugar. A transient decrease in immunity because of the suppressive effect of the steroid. Read more...

How much pain is involved with getting epidural steroid injections?

No to minimal pain. If done properly there should be no pain during and after procedure. Read more...
Minimal. Typically, the initial numbing medication can burn a little. The actual injection into the epidural space should be relatively painless. Read more...
Minimal. Everybody has a different tolerance for pain. Epidurals should not be horribly painful. If done with sedation patients often don't recall the epidural at all. Without sedation patients will feel a little stick and a burn usually followed by some pressure. Certain types of epidurals known as transforaminal epidurals may cause pain to temporarily radiate down the leg during the epidural. Read more...
Expect an Injection. Epidural injections are common and if you have had any type of injection it should not be much different. The local anesthetic to numb the skin typically burns abit. Your doctor should be using fluoroscopic x-ray guidance to do this injection. Occasionally, you may feel back pain or a nerve pain sensation as the needle is placed appropriately and medication is instilled into your spine. Read more...
Actually minimal. Of course, there will be some local pain when needle inserted, but often, these are done under sedation. Typically, very little residual symptoms, and if done under appropriate circumstances, can turn problems around. Read more...

What medical issues could arise after repeated epidural steroid injections?

See below. Epidurals are often used to help relieve pain from an inflammed disc or pinched nerve. It's probably ideal to limit steroid injections to 3 per year as too much sterid can lead to osteoporosis or hormonal imbalances. Steroids can also increase blood sugar levels if your a diabetic. Read more...