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Toronto, AL M5N 2M7
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christian@orthogate.com






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Mother had a steroid injection for back pain that was coming from spinal stenosis. She got a lot of pain relief. I have a herniated disc and back pain from that. Would an injection like that help me?

Steroid injections into the epidural space have been used for pain coming from herniated discs as well as pain from spinal stenosis (narrowing of the spinal canal). This space is the area between the bony ring of the spine and the covering of the spine called the dura. The dura is the sac that encloses the spinal fluid and nerves of the spine. When doing an epidural steroid injection, the doctor inserts a needle through the skin so that the tip of the needle is in the epidural space. The epidural space is normally filled with fat and blood vessels. Fluid such as the lidocaine and cortisone that is injected during an injection 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 steroid injection is an antiinflammatory combined with a numbing agent. The dual effect is to reduce swelling around the spinal cord or spinal nerves and stop painful messages from being sent to the brain. There are several openings in the bones that surround the epidural space where a needle can be placed. Surgeons are fine-tuning the use of steroid injections to get the best results -- quick pain relief that is long-lasting. Although the steroid injection has the same biologic effects on local cells and tissues, where it is injected determines what areas are bathed in the drug. For example, discs tend to push backwards, putting pressure on the spinal cord from the front or anterior epidural space. The logical place to inject the steroid mixture is in the area where the spinal nerves are being compressed or irritated. So, yes, you could possibly benefit from this treatment. But there are other steps that can be taken first, which don't require needle injection into the epidural space. Your primary care physician can guide you through the steps of conservative care. Usually, an oral antiinflammatory drug is prescribed along with physical therapy. If you don't get any pain relief with these approaches, then a steroid injection might be considered.

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