Facet steroid injection risks

Although epidural steroid injections (also called epidural corticosteroid injections) may be helpful to confirm a diagnosis, they should be used primarily after a specific presumptive diagnosis has been established. Also, injections should not be used in isolation, but rather in conjunction with a program stressing muscle flexibility, strengthening, and functional restoration.
Proper follow-up after injections to assess the patient's treatment response and ability to progress in the rehabilitation program is essential. A limited number of injections can be tried to reduce pain, but careful monitoring of the response is required prior to a second or third injection.

An epidural steroid injection involves bathing an inflamed nerve root in steroids (potent anti-inflammation medicine) in order to decrease the irritation of the nerve root that is causing pain.  Epidural steroid injections are most commonly used in situations of radicular pain, which is a radiating pain that is transmitted away from the spine by an irritated spinal nerve. Irritation of a spinal nerve in the low back (lumbar radiculopathy) causes pain that goes down the leg. Epidural injections also are used to treat nerve compression in the neck (cervical spine), referred to as cervical radiculopathy.

This is a rare complication that may occur if a small hole is made in the fibrous sac and does not close up after the needle puncture. These small holes are only made in less than 1% of epidural injections and usually heal on their own. The spinal fluid inside can leak out, and when severe, the brain loses the cushioning effect of the fluid, which causes a severe headache when you sit or stand. These types of headaches occur typically about 2-3 days after the procedure and are positional - they come on when you sit or stand and go away when you lie down. If you do develop a spinal headache, it is OK to treat yourself. As long as you do not feel ill and have no fever and the headache goes away when you lay down, you may treat yourself with 24 hours of bed rest with bathroom privileges while drinking plenty of fluids. This almost always works. If it does not, contact the radiologist who performed the procedure or your referring physician. A procedure (called an epidural blood patch) can be performed in the hospital that has a very high success rate in treating spinal headaches.  

Facet joint arthritis often manifests as a dull ache across the back. However like many deep organs of the body it can be experienced by the patient in a variety of referral pain patterns. The location of facet joints, deep in the back and covered with large tracts of paraspinal muscles , further complicate the diagnostic approach. Typically facet joint arthritis is diagnosed with specialized physical examination by specialist physicians. Advanced imaging such as MRI or CT may be necessary to confirm the diagnosis and to rule out other conditions.

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Facet steroid injection risks

facet steroid injection risks

Facet joint arthritis often manifests as a dull ache across the back. However like many deep organs of the body it can be experienced by the patient in a variety of referral pain patterns. The location of facet joints, deep in the back and covered with large tracts of paraspinal muscles , further complicate the diagnostic approach. Typically facet joint arthritis is diagnosed with specialized physical examination by specialist physicians. Advanced imaging such as MRI or CT may be necessary to confirm the diagnosis and to rule out other conditions.

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