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Epidural steroid injections (or “pain blocks”) are performed for back
and leg pain that has not responded to other, more conservative,
treatments. The leg pain (which is called sciatica) is usually caused by a
damaged disc. It is believed to be caused by nerve root inflammation.
Steroids are potent anti-inflammatory medications. They may alleviate the
pain by relieving the inflammation.
A recent large research study, presented at scientific meetings in New
Orleans, showed that epidurals were effective in providing early pain
relief. About 60 percent of recipients had improved in three weeks. The
study looked at “blind” injections (which are done without the help of
X-ray). Selective blocks use a higher precision technique and are done
with an X-ray fluoroscope. They probably give even better results.
Many clinicians believe that damaged discs heal with time. Steroid
blocks seem to provide symptomatic relief while the damaged disc is
healing. They can be repeated if needed.
Common sense would dictate that patients should try the least invasive
treatments before surgery. If rest, therapy, and chiropractic do not work,
steroid shots may be appropriate. If these do not help, a surgery may be
needed.
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