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 ), such as from lumbar spinal stenosis , cervical spinal stenosis, herniated disc , and foraminal encroachment, causes back pain that goes down the leg. Epidural injection is also used as a minimally invasive procedure to treat nerve compression in the neck (cervical spine), referred to as cervical radiculopathy , which causes pain.
18 trials (1179 participants) were included in this updated review . The injection sites varied from epidural sites and facet joints (. intra-articular injections, peri-articular injections and nerve blocks) to local sites (. tender- and trigger points). The drugs that were studied consisted of corticosteroids, local anesthetics and a variety of other drugs. The methodological quality of the trials was limited with 10 out of 18 trials rated as having a high methodological quality. Statistical pooling was not possible due to clinical heterogeneity in the trials. Overall, the results indicated that there is no strong evidence for or against the use of any type of injection therapy .
The benefits from the first shot only lasted 2 weeks. The second and third set of injections lasted about 90 days. In November, I was ready to have surgery. My EMG and nerve conduction tests proved that the nerves were "sleeping" before I was. After another MRI, the neurosurgeon said I was a candidate for surgery but I was not able to get the endoscopic type surgery that is less invasive. I would have an incision about 6-8" long. Along with removing the herniation, they would have to increase the size of the hole where the nerve roots were going through.