The foramen is the opening between the spinal vertebra where the spinal nerve exits the spine and travels to the body. Any structure that encroaches on this opening can compress the nerve producing inflammation and pain along the distribution of that nerve.
Causes of Encroachment and Nerve Inflammation
- Bulging or herniated discs
- Disc Degeneration
- Arthritic degenerative changes that narrow the intervertebral foramen
- Spinal Canal Stenosis
- Disc inflammation that release irritating enzymes
Indications and Symptoms Treated with Epidural Steroid Injections
- Burning pain in back or neck that radiates into the arm or leg
- Numbness and tingling into the arm or leg
- Back or neck pain with muscle spasm
- Months of conservative care with minimal relief or residual symptoms
This procedure is the targeted placement of an anesthetic and anti-inflammatory solution in the epidural space at the intervertebral foramen where the disc and nerves are located. The purpose of this injection is to decrease inflammation and irritation around the disc and nerve roots before they exit the spine thereby reducing your pain. The procedure may be repeated periodically, if necessary, and is an important part of treating conditions such as herniated discs, sciatic pain (radiculopathy), spinal stenosis and degenerative disc disease. It can be performed in the cervical, thoracic or lumbar regions. All procedures are done under fluoroscopic guidance (X-ray-guided) to ensure proper placement of the medication and may be performed in an ambulatory surgical center, fluoroscopy suite or hospital setting.
The procedure usually takes about 30 minutes. There may be an increase in discomfort the first 2-3 days following the procedure as the numbing medication wears off. The full therapeutic effect and pain relief from the epidural injection may take up 10 days after the injection. One of the goals of the epidural injection is to reduce the inflammation at the site of the problem and provide enough pain relief to allow the patient to progress with their rehabilitation program.