Spinal stenosis isn’t just a pain in the back — in the case of lumbar spinal stenosis, it causes pain that radiates down your legs, making many movements (and even standing still) uncomfortable. Stenosis is caused when enlarged facet joints or bone spurs compress the nerves that extend from the spine, and this pressure results in pain at the site the nerve serves. Though some people are able to manage pain from stenosis with conservative treatments like exercise and behavior modifications, for others the pain becomes disruptive to the point of needing a stronger intervention.
Epidural steroid injections are often considered as a conservative treatment for stenosis. Anti-inflammatory medications (usually corticosteroids) are injected, along with a local anesthetic, to help reduce the pain and swelling at the site where the nerves are being squeezed.
Though relief from epidural injections is generally short-term — usually a period of less than a month — some are now questioning whether these are even enough to treat the pain from spinal stenosis. A 2014 study published in the New England Journal of Medicine did not find significant differences in self-reported pain relief from patients who received injections that combined steroids with a pain reliever and those who were injected with the pain reliever alone.
That said, for some patients an epidural injection can be used as something of a diagnostic tool. Patients who do experience relief from injections, even if it is short-term, often have a good prognosis should they choose to have surgery to help relieve the pressure on their nerves. Epidural injections are very carefully targeted — an MRI or other imaging is done first, and the injection itself is guided by fluoroscopy, which is like a live x-ray. If the target has been “hit,” the patient and the doctor can know that they have accurately located the source of the pain.
Are you suffering from chronic pain due to spinal stenosis? Call the Spine Institute Northwest at (425) 486-1000 to find out more about how we may be able to relieve your pain.