By Amit Poonia, M.D.
Many patients with chronic back, arm or lower leg pain realize how debilitating and painful it can be. Oftentimes it’s hard to make any movements and the pain can travel down your arms or legs on an ongoing basis. If this type of pain seems all too familiar to you, then a visit to Interventional Pain Management and Ortho-Spine Center is long overdue. There are two locations in Ocean County in Toms River on Lakehurst Road and Hooper Avenue.
What is an epidural steroid injection (ESI)?
This is a minimally invasive procedure that can help with neck, back and arm or leg pain caused by spinal stenosis or disc herniation. There has been great success for many patients using ESI to relieve this type of pain, which is mostly caused by inflamed spinal nerves.
How is epidural steroid injection administered?
Medicines are delivered to the spinal nerve through the epidural space, the area between the protective covering of the spinal cord and vertebrae. The goal of the epidural injection is to relieve the symptoms of pain without depending primarily on oral medications that could have unpleasant side effects like stomach ulcers, or injuries to the liver or kidneys. In some cases, the injections can help postpone or even avoid surgery. In addition, the procedure will complement surgery in situations where surgery has resulted in incomplete relief of pain, or the possible onset of new pain after a surgery.
An ESI is a same-day procedure that doesn’t require admission to a hospital or an overnight stay. It takes about 10-15 minutes to perform and is done under the guidance of a special x-ray machine called fluroscope. This device takes multiple images of the spine during the injection. The patient is positioned on his or her abdomen and the target area is cleaned with an antiseptic solution. Next, a very fine needle is advanced under direct vision using the x-ray machine until placed in the correct position. An iodine-based dye is injected in real-time to confirm the proper placement and a low dose steroid is administered. Once the needle is removed and the site is covered with a Band-Aid, the patient will walk out of the room and wait approximately 15-20 minutes before going home. Sedation is available for those who prefer it. everyone is different and it’s a very personal decision that has to do with his or her own level of anxiety.
How many injections are required?
Most conditions require multiple sessions and the general consensus is to perform up to three epidural injections per year. There are some patients who require only one session; it depends on the severity of the condition and how many nerves are involved.
What are the success rates of ESI?
The benefits of ESI tend to be temporary and the duration of relief can vary from weeks to several years. If necessary, the patient can have successful epidurals repeated in the future after discussing it with their physician.
The board-certified physicians at Interventional Pain management and Ortho-Spine Center are experienced in pain management and treatment. They care for each patient as an individual in reaching diagnosis and determining the optimal treatment plan to achieve the best possible results. They support a multidisciplinary team-based approach to the prevention, evaluation, diagnosis and treatment of painful disorders. The offices offer advanced techniques, including interventional pain procedures and pharmaceutical treatment to address complex multidimentional pain systems.
Amit Poonia, M.D. is on staff at Interventional Pain Management and Ortho-Spine Center. For more information or office locations, call 800-403-1533 or visit statewidepain.com.