Epidurals — injections near the spine that relieve pain — are useful in a variety of circumstances including during and after surgery and managing chronic pain
What are epidural therapies?
Epidurals can be an excellent option for pain relief because they last for long periods of time and the relatively low dose of medicine involved produces fewer side effects than most other options.
Epidural therapies work by targeting the epidural space located immediately outside the membrane that incases the fluid surrounding the spinal cord.
Types of epidural therapies
There are two types of epidural therapy: epidural nerve blocks and epidural injections. The nerve block option is the most widely-used and works as an anesthesia, administered through a tube to the base of the spine. This targets the nerves that transmit pain signals to the brain and is administered throughout some surgeries and childbirth. Unlike local anesthetics, nerve blocks still allow the individual to feel touch and pressure but it is only effective on the lower half of the body.
Epidural injections are administered to any area along the spine and different medications can be used. For example, steroids can be injected and target pain and swelling in most parts of the body. This can relieve issues such as a herniated disk or pinched nerves as well as help locate any unknown source of pain. In order to determine the correct place to administer the injection, a doctor will use special X-ray dye that will indicate the best location along the spine that is near the pain-causing nerve. The benefits from this therapy vary from person to person but can last for months.
Side effects of epidural therapy
Both epidural options come with the risk of infection, headache, bleeding or nerve damage. There are also a number of conditions that increase the dangers of epidural therapy including:
- Blood clotting – if there is a history of blood clots an epidural can increase the chance of complications
- Drug allergies – individuals who are known to have reactions to anesthesia drugs will need to seek other pain relief options
- Infection – if an infection is already present, an epidural can worsen the issue
- Diabetes – unmanaged diabetes can dramatically increase the risk of side effects
- Drug interference – if a patient is already taking medication for pain relief it is important to make sure it does not interfere with the epidural
Steroid injections should be limited to a few times per year due to the risk of weakening bones and muscles. Because these epidural drugs mimic hormones, it is possible that they might upset the body’s natural hormone balance. Other side effects include high blood sugar, insomnia and skin thinning/change in color.
A medical professional will be able to help weigh these potential risks against epidural therapy benefits and choose the proper option for your pain management needs.