Herniated Disc Epidural
A herniated disc is a very painful condition whereby the thick outer wall of a lumbar disc weakens, splits, and eventually tears to allow the softer tissue within to squeeze through. This unfortunate series of events can happen as a result of natural aging, or as the result of a lifting accident, but however it occurs, there are a number of treatments available to alleviate symptoms, including a herniated disc epidural injection.
The first course of treatment for a herniated disc should be some form of physical therapy in conjunction with painkillers and anti-inflammatory agents. The majority of people find that adequate pain relief combined with physical mobilization for six weeks will be enough to resolve their symptoms. But for the few who continue to suffer with recurring symptoms, further investigation followed by more radical treatment is a necessity.
A herniated disc epidural, also known as a caudal epidural, is usually the next stage of treatment following an MRI scan to confirm the diagnosis of the prolapsed disk. Since most of the pain of a herniated disc is related to inflammation around the nerve roots, an epidural can offer pain relief as well as a strong anti-inflammatory agent at the source of the pain.
The epidural works by injecting a strong dose of synthetic hydrocortisone into the nerve root, unlike natural cortisone which is administered into the bloodstream. This reduces inflammation and allows the herniated disc to heal naturally. Epidural hydrocortisone treats the chemical irritation of the nerve as well as providing pain relief and is designed to be longer lasting and much more potent.
During the herniated disc epidural procedure, the patient lies face down. An X-ray is used to pin point the location for where the injection needs to be administered. The epidural is a day case or overnight procedure. The injection normally lasts around 15 minutes and patients are given light sedation. Sedation is used as opposed to a general anesthetic to allow accurate placement of the needle. If the needle gets too close to the nerve, the patient will be able to let the doctor know.
Typically a series of around three injections are given and are generally spaced a week apart. This is normally enough to provide relief from long term herniated disc pain and inflammation.
Side effects of an epidural are rare but can occasionally occur. Infection occurs in less than 0.5% of procedures and can be entirely avoided by using sterile techniques. Bleeding is also unusual and can be prevented by not performing the procedure on patients who are taking blood thinning medication or who have any kind of blood disorder. Dural tears are caused by the injection piercing the sac that protects the spinal nerves. The main symptom of this occurrence is a headache following the procedure. An increase in blood sugar can occur following this or any other steroid injection and diabetics should carefully monitor their blood sugar levels after the injection.
The vast majority of the time, a herniated disc epidural injection will provide lasting relief from the pain of a herniated disk, but if this procedure fails to provide a long term solution, the next course of treatment is surgical intervention. This involves removal of the fragment of disk that is causing irritation of the nerve roots.