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Treatment of Low Back Pain with an Epidural Steroid Injection

 Dr. Anthony Guarino treats patients at:

Barnes-Jewish West County Hospital
Washington University Pain Management Center
969 North Mason Road, Suite 240
St. Louis, MO 63141

Phone:  314-996-8631     Fax:  314-996-8742

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Question:  I have low back pain that goes into my left leg. My sister had a similar problem and received an epidural steroid injection into her back and now she feels much better. Could an injection help me?

Answer:  Low back pain can be caused by several different factors, including muscles, ligaments, nerves, disc problems and stress. If back pain is accompanied with a change in your bowel or bladder function, loss of sensation in the groin or loss of use of a leg, then you have a potential emergency situation and should go directly to the emergency room for an evaluation and treatment.
 
When the pain extends down the buttock and leg it is caused by an irritation to a nerve in your back. This “radicular pain” can indicate a problem with the sciatic nerve or a disc in the spine.
 
The first month of low back pain therapy is oriented to helping control symptoms while waiting to see if the body heals itself. Initial treatment for this type of pain may include anti-inflammatory medications, muscle relaxants and physical therapy.
 
If symptoms do not resolve after a month, testing may occur in order to help diagnose the cause of the pain. Your doctor may order a MRI or CT scan of your back. Epidural injections have been helping people with back pain for over 50 years and are one of the most common injections a doctor will perform.

Back injections are considered when reasonable conservative attempts to treat the pain during the first month are ineffective. Using a special type of x-ray called fluoroscope, the doctor places a small needle into the epidural space and injects a steroid near the nerves causing the pain. Bathing the nerve with a steroid solution helps to reduce inflammation and swelling.
 
For some people, epidural injections will totally alleviate the pain, but for many the pain relief is only temporary – lasting from a few weeks to a year. That is why it is important during the period of pain relief to participate in an exercise or physical therapy program which will improve back function and increase muscle strength. Epidural injections can be repeated up to three times within a twelve month period.
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Copyright 2013 Washington University School of Medicine