Pain Management

January 3, 2022

Which Type of Steroid Injection is Right for Your Pain?


Steroid injections are often used to alleviate chronic or long-term pain in joints or the back when prescription medications and topical treatments haven’t been effective. Pain specialists usually administer the injections in a clinic or hospital setting. In some cases, steroid injections may also be used to calm the area to allow healing prior to surgery.

Your doctor will usually recommend non-invasive options like pain medications and physical therapy before considering an epidural injection. If these options haven’t brought you any relief or you’ve had an adverse reaction to them, steroid injections will usually be tried as the next step.

Which Kind of Steroid Injection is Right for You?

Only your doctor or surgeon can determine which kind of steroid injection may be most effective for your back, leg, or neck pain. The type of steroid injection you receive depends on what kind of pain you’re experiencing.

Foraminal Epidural Injections

Sometimes referred to as transforaminal injections, foraminal epidural steroid treatments are usually reserved for patients with back or leg pain. The goal is to relieve the pain and improve your range of movement and mobility without resorting to surgery. In many situations, foraminal epidural injections can help for weeks or months at a time. Foraminal injections are administered into the side of the spinal cord rather than the base of the spine.

Foraminal epidurals are most commonly used to treat the pain of sciatica, which radiates down the leg due to the compression of specific spinal nerves. It is also widely used to treat lower back pain caused by inflammation of nerves or compression of discs in the spinal column. There are several causes of sciatica and lower back (lumbar) pain, including a herniated or slipped disc, spinal stenosis (a narrowing of the spinal column that puts pressure on your spinal cord), and spondylolisthesis (vertebrae that shift out of alignment).

Lumbar Epidural Steroid Injections

Lumbar epidural steroid injections (LESI) are used to alleviate lower back pain and leg pain. Lumbar injections are similar to foraminal epidurals, but they are given directly into the spinal cord through the base of the spine. The pain relief from a lumbar injection can last for weeks or months and is often used in conjunction with physical therapy to improve your range of motion once the pain and inflammation are reduced.

Lumbar epidural injections are more effective for certain types of back and leg pain, such as sciatica or a slipped disc, and less effective for spinal stenosis. If your symptoms are relatively recent, the epidural is more likely to be effective. For most patients, pain relief will last for weeks, although it can last for months for some. If you get partial relief from one injection, your doctor may recommend doing up to four injections over a few weeks, but only if the pain continues to diminish.

Facet Injections

Facet injections use steroids, anesthetics, or a combination of the two. They are sometimes referred to as facet joint blocks because they temporarily block pain signals. The goal is to calm inflammation and reduce pain, particularly in the neck and back, caused by inflammation of the facet joints (the small joints between the vertebrae).

Facet joint injections are most effective against arthritis, degenerative disc disease, or specific injuries. While epidural injections are administered near nerves in the spinal area that cause pain, facet joint injections are more targeted. They are also used as a diagnostic tool to help surgeons determine whether your pain is originating in the facet joint or caused by another issue.

The Pros & Cons of Steroid Injections for Pain

Steroid injections can provide lasting pain relief when topical treatments, medications, and physical therapy have failed. If you suffer from chronic, debilitating pain, steroids can help you get back on your feet and back to work and other activities. Most side effects are minor, such as an elevated temperature for a few days, flushing, temporary insomnia, and minor pain at the injection site.

However, steroid injections will not cure the condition causing your pain. They are a temporary treatment to minimize or alleviate your pain, but they will wear off over time. When the steroids stop working, you will have to repeat the procedure. Because the long-term effects of steroid injections may include weakness of the bones or tendons at the injection site, your physician will strictly monitor how frequently you get the procedures performed.

Your doctor will go over the pros and cons of steroid injections with you in detail. It is essential to understand that every patient reacts differently to steroid injections of any kind. While you may experience an almost complete cessation of pain for weeks or months, someone else may feel only minor relief that lasts for a short time. It is virtually impossible to know how well you will respond, but the skilled physicians at Arkansas Surgical Hospital will be able to give you a good idea of what to expect based on your condition, its severity, and how you’ve responded to past interventions.

Are Steroid Injections Right for You?

The spine surgeons and pain management specialists at Arkansas Surgical Hospital will evaluate your level of pain, general medical history, and risk factors to determine whether steroid injections will be beneficial to you. Diagnostic testing, including x-rays, MRIs, and facet injections, will give your doctor a more complete picture of what is going on and which treatments will be most effective. The length and severity of your pain are also a consideration, as not all forms of steroid injection work well for pain that’s been established for an extended time.

If you’ve been coping with chronic or long-term back, neck, or leg pain, contact Arkansas Surgical Hospital to schedule an appointment with one of our specialists. They will work with you to determine which type of steroid injection or other intervention is appropriate for your pain.

Photo by Thirdman from Pexels

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