Not to be mistaken with the epidural administered during pregnancy labor and prior to childbirth, injecting medication to the spine has been an option widely considered by patients with low back pain. Whether they experience leg pain or not, or if their inflammation is related to disc herniations, more people are asking for this type of treatment. But did you know that, in particular, epidural steroid injections are not the best course to treat back pain?
This week’s episode features Dr. Andrew Sumich of Carolina Neurosurgery and Spine Associates, whose expertise revolves around musculoskeletal medicine and interventional spine care. He dives deep into the role of spinal injections as it relates to alleviating back pain, particularly steroid injections. In particular, he makes the distinction of an epidural steroid injection, which is better for relieving symptoms and helping the physician make an accurate diagnosis.
Dr. Sumich shares the different techniques used to administer medication to the spine and what they’re typically comprised of. While these procedures are relatively safe, there are still some risks present. However, if the right equipment is used and a skilled doctor is following the processes, then the chances of any serious complications are minimal to none. Though this is the case, he also cautions about having too many injections done frequently. This means that the treatment may not be effective and a minimally-invasive surgical procedure may be a better alternative.
For Dr. Sumich and Dr. Lakhvia, common sense should rule when it comes to using spinal injections for back pain. You should always consult with your doctor to know which option is the best to treat this problem.
Key moments in the episode
- Role of spinal injections for back pain 06:12
- What is an epidural steroid injection 07:11
- Techniques to inject steroids for pain relief 09:30
- Risk and complications 11:24
- Transforaminal epidural steroid injection vs. selective nerve root block 12:52
- Types of medication administered and what happens during the procedure 15:02
- Risk for spinal cord injury 16:32
- Deciding factors for choosing surgery over epidural steroid injection 21:07
- Number of injections usually done 24:38
- Other options for back pain 27:51
- Research on biologic or regenerative agents for back pain 30:56
- Challenges to disc healing 34:29
- Personal approach to maintain health and wellness 42:30
Every episode of Back Talk Doc includes a Health Matters segment intended to provide actionable health information you can immediately put into practice in your life. This week, Dr. Lakhia discusses vitamin D, which is not only essential to maintaining good health, but can reduce back pain. This is because this fat-soluble vitamin can control inflammation by lowering levels of C-reactive protein and inflammatory cytokines.
The correlation was seen in a study that showed a strong reduction of pain in patients who were given 3200 international vitamin D supplements every day for 5 weeks. More research is still being done, but the results have so far been positive. So, if you’re planning to consume more vitamin D, consult with your physician first and have your vitamin D levels checked.
Links mentioned in the episode
- Intracept procedure
- Preoperative Supplementation with Vitamin D, Attenuated Pain Intensity and Reduce the Level of Pro-Inflammatory Markers in Patients After Posterior Lumbar Interbody Fusion, Frontiers in Pharmacology Journal, May 2019
Back Talk Doc is brought to you by Carolina Neurosurgery & Spine Associates, with offices in North and South Carolina. To learn more about Dr. Lakhia and treatment options for back and spine issues, go to backtalkdoc.com. To schedule an appointment with Carolina Neurosurgery & Spine Associates, you can call us at 1-800-344-6716 or visit our website at carolinaneurosurgery.com.