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Corticosteroids And Anesthetics For Spinal Disc Pain
(Cortisone Injections, Epidurals And Oral Steroids)
Dr. Ron Daulton, Jr.
Corticosteroids and Anesthetics are used in the injections that are given for spinal disc problems, as well as many other back problems and joint conditions. Usually they are referred to as steroid injections or epidurals, and most of the time, the injections actually include a combination of the two types of medications.
In addition to that, your doctor may prescribe corticosteroids as a medication you would take orally.
The medications that are included in this group include:
- Corticosteroid injection
- Methylprednisolone (Solu–Medrol, Medrol, Depo–Medrol, Hybrisil, A–Methapred)
How Do Corticosteroids Work?
These types of medications help with pain by reducing inflammation. I discussed how inflammation works in great detail when we discussed NSAID’s previously, so I won’t go into a lot of detail here (if you would like to read about that, you can click here to go to that page).
However, even though these work the same as NSAID’s do, they are much stronger. BUT they also have more serious side effects that can potentially occur. One of the biggest concerns with these is that they can cause the joint that is injected to deteriorate more quickly (in other words, you will develop arthritis in that joint faster than you should). It can also cause the bone surrounding the joints to become infected or destroyed, which can lead to osteoporosis (bone loss) and other complications. So you have to be careful with these.
That is the reason why the number of injections you can have is limited to 3 per year typically (in the same joint). The risk is just too high that you will end up damaging the joint and creating a new problem besides the disc problem you are already dealing with.
How Do Anesthetics Work?
When a person has an epidural, the type of medication that is injected is called an Anesthetic. The procedure is actually named that because of where the medication is being injected (the epidural space that surrounds the spinal cord).
The medication will block nerve impulses in that area, which numbs everything that is controlled by those nerves.
What Does The Research Have To Say About Epidural Injections For Spinal Disc Conditions?
According to a research study entitled, "Increases in lumbosacral injections in the Medicare population: 1994 to 2001," which was done by Friedly, Chan & Deyo in the journal Spine in July of 2007, these types of injections are effective as little as 18% of the time. And even with such a low success rate, there was an increase in their usage by 271% between 1994 to 2001, which added up to an additional $175 million dollars in charges from this service alone! The outcome of the study was that this is not the best option for treating disc conditions, and it certainly isn’t the most cost–effective!
Also, when injections do help a person, it can be very deceiving because, yes, the pain goes away but the problem is that the underlying disc condition didn’t actually heal, so you think that you’re okay and you continue going about your life and doing all the things that got you into this problem to begin with and then once the injection wears off, all of a sudden the pain comes back and sometimes it’s even worse and it’s more difficult to treat at that point.
Does that mean you shouldn’t consider having these injections? Absolutely not – that is something you have to discuss with your doctor because in some cases, they can help. And even if they help temporarily, sometimes they can reduce the pain enough that you can start doing everything you need to do to start the healing process. We’ll talk about what those steps are at the end of this article.