Back pain and ESI are related to each other in that the latter is very often used to find out the true cause of the former. Backache is a common phenomenon and is generally a result of a strain or injury to the muscles and ligaments supporting the human spine. An Epidural Steroid Injection or ESI is the most common type of injection given to patients suffering from back and neck pain. The pain in the back can be constant or intermittent and its intensity may vary from a dull ache to a searing feeling.
In many cases, back pain vanishes or can be cured within a few weeks. However, in cases of chronic pain, medical advice is necessary. Patients having difficulty in passing urine or experiencing numbness in the back or genital area or weakness and pain in the legs or feeling unsteady while standing should see a physician immediately. Spinal injections are often used to find out the true cause of the back pain and then to actually treat the pain. Injections that provide temporary relief are called therapeutic injections. In other cases, spinal injections are used to diagnose the cause of the back pain. ESI is generally an injection used to treat back pain.
The space between the covering of the spinal cord and the inside of the bony spinal canal is called the epidural space. An injection in this area ensures that the medication moves across the whole of the spine and covers all the nerve routs and joints to relieve the back pain. ESIs are generally very effective in the treatment and the true diagnosis of back pain.
In most of the cases where spinal injections are used, a local anesthetic called Lidocaine is used. Lidocaine is a fast-acting drug and its effects wear off in a couple of hours. So it is generally used as a diagnostic tool. Bupivacaine, another anesthetic is used to provide some relief from the back pain. Another commonly used injection is Cortisone. Cortisone is commonly injected with a local anesthetic to reduce inflammation in the affected areas of the patient suffering from severe back pain.
An epidural steroid injection or ESI can be injected in three different ways. In the first case, a caudal block is placed through the sacral gap which is the space below our lumbar spine. Then the injection is placed into the epidural space. This type of block reduces the chances of puncturing the dura.
The most common method of giving an ESI to reduce back pain is the Tran lumbar approach. Under this method, the needle is placed between vertebrae from the back. The third method is generally used for diagnostic purposes. The transforaminal approach involves the injection of the medication around a specific nerve root to find out the exact problem area. The foraminae are small openings between your vertebrae through which the nerve roots exit the spinal canal and enter the body.
Spinal injections should not be used in the case of patients taking a platelet-inhibiting drug, such as aspirin or NSAIDs (non-steroidal anti-inflammatory drugs).