Epidural steroid injections for low back pain and lumbosacral radiculopathy.
Non-surgical treatments of back pain may have prolonged and lasting benefit. Epidural steroid injections is one of the non-operative managements of back pain. These injections are recommended in patients with signs and symptoms of nerve root irritation. Relief of pain is attributed to the anti-inflammatory effect of the steroid. Patients with acute radiculopathy have better response compared to patients with chronic symptoms. Improvement may not be noted until 6 days after the injection. The depression of the hypothalamic-pituitary-adrenal (HPA) axis lasts 3 weeks. While complications have been reported, these are rare. Intrathecal steroid injection is not advisable since polyethylene glycol, the vehicle used in depot steroid preparations, may cause arachnoiditis.
D000767:Anesthesia, Epidural; D001416:Back Pain / Q000188:drug therapy* / Q000209:etiology; D002045:Bupivacaine; D002986:Clinical Trials as Topic; D004824:Epidural Space; D005938:Glucocorticoids / Q000627:therapeutic use*; D006801:Humans; D007030:Hypothalamo-Hypophyseal System / Q000187:drug effects; D007267:Injections / Q000009:adverse effects; D007278:Injections, Spinal; D007405:Intervertebral Disc Displacement / Q000150:complications / Q000188:drug therapy / Q000628:therapy; D008161:Lumbosacral Region; D008775:Methylprednisolone / Q000627:therapeutic use; D009408:Nerve Compression Syndromes / Q000188:drug therapy / Q000209:etiology; D010523:Peripheral Nervous System Diseases / Q000188:drug therapy*; D010913:Pituitary-Adrenal System / Q000187:drug effects; D011343:Procaine; D013126:Spinal Nerve Roots; D014221:Triamcinolone / Q000627:therapeutic use
D005938:Glucocorticoids; D014221:Triamcinolone; D011343:Procaine; D008775:Methylprednisolone; D002045:Bupivacaine