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Q.

I have persistent low back pain and my doctor suggested epidural injections. How well do they work? What are the risks?

 

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A.

The effectiveness of epidural injections depends on a number of factors. The most important factor is the cause of your pain. For example, if pain is due to muscle spasm, an epidural injection is unlikely to be helpful.

Epidural injections usually include a combination of corticosteroids and a numbing medicine in the family of Novocain. The needle is inserted into the space just outside the spinal cord (called the epidural space). These injections are most commonly recommended to treat:

  • Osteoarthritis (or degenerative joint disease)

  • Disc disease

  • Spinal stenosis (a narrowing of the space where the spinal cord resides).

Studies of epidural injections suggest that they can be helpful for these conditions. However, not all studies demonstrate significant benefit. And even the ones that find benefit suggest that the primary role of epidural injections is to provide temporary pain relief for certain conditions.

As with any other treatment, epidural injections are not risk-free. The most common side effects include:

  • Discomfort or numbness during the injection

  • Headache, nausea and vomiting

  • Infection

  • Bleeding along the path of the needle

  • Nerve damage

Because of these risks, epidural injections are usually offered only occasionally (for example, a few times a year) and only for conditions in which improvement can be reasonably expected (such as those listed above). In addition, epidural injections are typically offered when other, less-invasive treatments (such as pain medications and physical therapy) are not effective.

Doctors performing these injections usually use a type of X-ray to confirm the proper location of the needle prior to injection. This helps limit complications. Fortunately, serious complications or side effects, such as infection or nerve damage, are quite rare.

Copyright 9/13/2010 Harvard University. All rights reserved. HHP/HMS content licensing handled by Belvoir Media Group.

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A.
Before I started injecting anywhere, effects are very often temporary. When you say low back is that right side left side? Does it come and go? If so Try this put on a pair of hard soled shoes and walk where you can hear your foot step clearly you are trying to identify a heavy foot fall. The clop is indicative of the shorter leg the shorter the leg the louder the clop. If you hear this difference you need to get a weight and balance study which is nothing more than a pelvic xray that will determine the short leg for sure and how much lift you will need in that shoe to correct a problem that nearly everyone has. Once you are walking on balanced legs the muscles in you low back with develop evenly and wow no more back pain. The short leg if it is present didn't happen over night so think of it as constantly stepping into a low spot in the lawn, you are pounding everything on that side of the spine so go for correcting the clop and then stretching out the spine to help realign things and help fluid refill the disks hopefully alot of damage is not done. The required lift can be applied right to the heal of your shoes or be made to fit into any shoe you own. A good cobbler will be able to make it out of leather. After a couple of days with the lift in action you may get  a little sore.That is because you are now using muscles that just went for the ride, but as things get stronger if there is not a lot of damage already done your low back pain will be a thing of the past.

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