Cervical Radicular Pain

 

Cervical radicular pain refers to a painful nerve from the neck going down the arm. Radiculopathy is a condition of the spinal nerve roots that usually causes a patient to feel pain, weakness, and numbness radiating from the neck. Patients often describe radicular pain as radiating, sharp, shooting, and/or electric-type pain and may be associated with numbness or weakness in the upper extremity.  Link to an image of the cervical radicular pain patterns (dermatomes).

 

What are epidural steroid injections? 

Epidural steroid injections (ESIs) are a common treatment option for cervical radiculopathy. ESIs have been used for neck and arm radicular pains for decades and are still an important part of the non-surgical management.  The main goal of the epidural steroid injection is to reduce or eliminate the swelling in the irritated nerves, and to decrease any inflammation that surrounds the disc and the spinal nerves.  Because of the low risk and low incidence of any significant problems or side effects, this is felt to be a reasonable procedure to pursue when traditional conservative therapy for disc and nerve pain has failed to provide improvement. Dr. Chris Faubel and the MOI Spine Center does not use any of the type of steroids that were implicated with the fungal meningitis outbreak in 2012. We take great effort to maintain safety for our patients. 

 

How long will the steroid injection last? 

This is the most common question we get asked regarding epidural steroid injections.  The short answer is that the steroid injections work until the nerves are irritated enough that the inflammation and swelling returns.  This could range from weeks to months or even years.  

 

A large percentage of patients will get complete resolution of symptoms after one or two of these pain injections; a small percentage may experience no real improvement at all.  Additional injections have additive effect and are often recommended if only partial relief has been achieved.  If there is improvement from the steroid epidural, it likely will occur 2-4 days after the shot, but may take as long as a couple weeks.  The improvement should not be expected immediately, unless numbing medicine is combined with the steroid, which never happens in the cervical spine.  

 

Keep in mind that if the nerve is pinched too severely, the epidurals won't be effective; at this point surgery is needed. 

 

What can I do in addition to the epidural?

Sometimes the injection alone provides the patient with great relief.  Your doctor may also recommend a combination of different services in order to help you restore function and mobility.  It is important to take an active role in your healthcare in order to restore function and activities of daily living.  There are many effective tools once the pain begins to resolve.  Examples may include physical therapy, spinal manipulation, weight loss, exercise, massage therapy, or other various treatments.

 

Thoracic Radicular Pain

 

The thoracic spine is the mid-section of the spine.  Thoracic radiculopathy occurs when a spinal nerve root that exits from each side of each thoracic spinal segment is compressed or chemically inflammed.  This usually causes a patient to feel pain, numbness, and sometimes tingling radiating from the spine.  The symptoms are felt from the mid back and around to the chest or abdomen in the corresponding dermatome of the nerve root.  Link to an image of the thoracic radicular pain patterns (dermatomes).

 

What are epidural steroid injections? 

Epidural steroid injections (ESIs) are a common treatment option for thoracic radiculopathy. ESIs have been used for mid back pain that shoots around to the chest or abdomen for decades and are still an important part of the non-surgical management.  The main goal of the epidural steroid injection is to reduce or eliminate the swelling in the irritated nerves, and to decrease any inflammation that surrounds the disc and the spinal nerves.  Because of the low risk and low incidence of any significant problems or side effects, this is felt to be a reasonable procedure to pursue when traditional conservative therapy for disc and nerve pain has failed to provide improvement. Dr. Chris Faubel and the MOI Spine Center does not use any of the type of steroids that were implicated with the fungal meningitis outbreak in 2012.  We take great effort to maintain safety for our patients. 

 

How long will the steroid injection last? 

This is the most common question we get asked regarding epidural steroid injections.  The short answer is that the steroid injections work until the nerves are irritated enough that the inflammation and swelling returns.  This could range from weeks to months or even years.  

 

A large percentage of patients will get complete resolution of symptoms after one or two of these pain injections; a small percentage may experience no real improvement at all.  Additional injections have additive effect and are often recommended if only partial relief has been achieved.  If there is improvement from the steroid epidural, it likely will occur 2-4 days after the shot, but may take as long as a couple weeks.  The improvement should not be expected immediately, unless numbing medicine is combined with the steroid.

 

Keep in mind that if the nerve is pinched too severely, the epidurals won't be effective; at this point surgery is needed. 

 

What can I do in addition to the epidural?

Sometimes the injection alone provides the patient with great relief.  Dr. Faubel may also recommend a combination of different services in order to help you restore function and mobility.  It is important to take an active role in your healthcare in order to restore function and activities of daily living.  There are many effective tools once the pain begins to resolve.  Examples may include physical therapy, spinal manipulation, weight loss, exercise, massage therapy, or other various treatments.

 

Lumbar Radicular Pain

 

Lumbar radicular pain refers to a painful nerve from the low back going down the leg(s).  Lumbar radiculopathy is a condition of the spinal nerve roots that usually causes a patient to feel pain, weakness, and numbness radiating from the low back.  Patients often describe radicular pain as radiating, sharp, shooting, and/or electric-type pain and may be associated with numbness or weakness in the lower extremity.  Link to an image of the lumbar radicular pain patterns (dermatomes).

 

What are epidural steroid injections? 

Epidural steroid injections (ESIs) are a common treatment option for lumbar radiculopathy.  ESIs have been used for low back and leg radicular pains for decades and are still an important part of the non-surgical management.  The main goal of the epidural steroid injection is to reduce or eliminate the swelling in the irritated nerves, and to decrease any inflammation that surrounds the disc and the spinal nerves.  Because of the low risk and low incidence of any significant problems or side effects, this is felt to be a reasonable procedure to pursue when traditional conservative therapy for disc and nerve pain has failed to provide improvement. Dr. Chris Faubel and the MOI Spine Center does not use any of the type of steroids that were implicated with the fungal meningitis outbreak in 2012. We take great effort to maintain safety for our patients. 

 

How long will the steroid injection last? 

This is the most common question we get asked regarding epidural steroid injections.  The short answer is that the steroid injections work until the nerves are irritated enough that the inflammation and swelling returns.  This could range from weeks to months or even years.  

 

A large percentage of patients will get complete resolution of symptoms after one or two of these pain injections; a small percentage may experience no real improvement at all.  Additional injections have additive effect and are often recommended if only partial relief has been achieved.  If there is improvement from the steroid epidural, it likely will occur 2-4 days after the shot, but may take as long as a couple weeks.  The improvement should not be expected immediately, unless numbing medicine is combined with the steroid.

 

Keep in mind that if the nerve is pinched too severely, the epidurals won't be effective; at this point surgery is needed. 

 

What can I do in addition to the epidural?

Sometimes the injection alone provides the patient with great relief.  Your doctor may also recommend a combination of different services in order to help you restore function and mobility.  It is important to take an active role in your healthcare in order to restore function and activities of daily living.  There are many effective tools once the pain begins to resolve.  Examples may include physical therapy, spinal manipulation, weight loss, exercise, massage therapy, or other various treatments.