Diagnostic and therapeutic epidural steroid injections for neck and back pain

Epidural steroid injections are commonly used to diagnose and treat neck and back pain. These injections are placed in the epidural space of the spine, which is located between the vertebral bones and the protective covering of the spinal cord.

What is in an epidural steroid injection?

Most epidural steroid injections combine two types of medications: a short-acting anesthetic that numbs the area and a long-acting corticosteroid that reduces inflammation. These medications wear off over time, although the associated pain relief can last for several weeks or even several years. Some patients find that injections provide a greater amount of pain relief than oral medications, which treat the entire body rather than a specific source of pain.

The difference between diagnostic and therapeutic injections

When used for diagnostic purposes, the injections are placed near a specific nerve that is thought to be the source of a patient’s pain. X-rays are used to ensure that the nerve is targeted accurately. If the injection leads to significant and immediate pain relief, the targeted nerve is likely to be the cause of the patient’s symptoms.

When used as a form of neck or back pain treatment, epidural steroid injections are delivered into the part of the spine closest to the affected nerve. This may be the cervical spine (the neck), the thoracic spine (the middle of the back) or the lumbar spine (the lower back). Some conditions that can be treated with epidural injections include:

  • Spinal stenosis
  • Sciatica
  • Herniated discs
  • Degenerative disc disease
  • Pinched nerves

If recommended by a patient’s physician, several injections can be provided in a series. However, most medical professionals advise a maximum of three injections per year. Other nonsurgical treatments, such as prescription muscle relaxers, physical therapy and lifestyle changes, may be used to supplement the pain-relieving benefits of epidural steroid injections and help a patient resume daily activities.

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