Steroid Injections for a Herniated Disc – Who Responds Well?

At any one point in time, 1% of the US population is suffering from a lumbar herniated disc. The condition typically occurs when a piece of the intervertebral disc squeezes out from its confines and pinches on a lumbar nerve buy injectable steroids online with credit card. Think of a jelly donut with a tear in the outer portion, and some jelly squeezes out. The compression of the nerve root may spark up inflammation around the area, and that is what creates pain going down one’s leg called radiculopathy, or sciatica. Sciatica is often a burning, searing pain that is extremely painful and disabling for patients.

Epidural steroid injections for herniated disks are very popular treatments, and often work well to give pain relief and avoidance of surgery. But who does well with them? There are 2 types of epidural injections done currently. The first, an intralaminar epidural injection, involves steroid medication being placed just under the bone in back of the spine. These do work, but one of the current options is a transforaminal epidural steroid injection (TESI), where the pain doctor places the needle into a more specific area where the nerve root is actually being pinched as it exits the spine.

Since the problem is the pinched area, that is where the steroid medication works well. A new study out of Australia (Ghahreman, Pain Medicine 2011) looked at transforaminal injections for lumbar radicular pain from a herniated disc. The findings were very interesting. They round that transforaminal epidural steroid injections worked well for disc herniations that did not have severe nerve root compression, but small to moderate compression.

The theory behind their results was that with small to moderate compression, the body produces an inflammatory response for which steroids work well. The success rate in these instances was 75%, which is consistent with numerous other studies on the benefits of epidural injections overall for herniated disc with sciatica.

If the compression is severe, the results in the study were only 26% effective. The authors theorized that in those instances an inflammatory response was not as prominent so the steroid injection was not as successful. If in fact that is the case, in instances of severe compression a higher consideration towards surgery should be given. Especially if an individual has muscle weakness from the compression. At any rate, epidural injections are an excellent treatment to try and avoid surgery with a low risk profile. It just appears they work better for disc herniations that are present but not in the severe category.

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