Number of epidural steroid injections safe across a lifetime
Epidural steroid injections (ESIs) are a common treatment for chronic low back and neck pain caused by conditions that irritate and inflame the spinal nerve root. However, like any medical procedure, ESIs come with potential risks and considerations.
While up to 3-4 ESIs per year per spinal region is a common guideline, healthcare providers tailor the frequency based on symptom recurrence, patient response, health status, and safety considerations. Factors influencing how many injections a person can receive include return of symptoms, underlying condition severity, patient’s overall health and response to previous injections, contraindications like rapidly progressing neurological deficits or infection, and medications like blood thinners that increase bleeding risk.
It's important to note that guidelines on using ESIs do not specify a safe number for a lifetime. Instead, they recommend limiting the number of injections a person has per year. Some sources specify a maximum of four ESI sessions per 12-month period per spinal region (cervical, thoracic, or lumbosacral) regardless of the number of injection levels within that region.
People with pain that spreads from their back to their buttocks or their neck down their arm should contact a doctor. While ESIs help relieve pain for a certain time, they cannot cure it. It's crucial to inform your healthcare professional about the effectiveness of the ESI, as they may use pain scales to communicate and measure a person's pain, and use this to assess medication dose and efficacy.
The Food and Drug Administration (FDA) has issued a warning about rare but serious effects, including vision loss, stroke, and paralysis, from epidural steroid injections (ESIs), but these side effects come from anecdotal reports, not scientific studies. Most side effects from ESIs are minor, and common minor side effects include vasovagal effects such as pale color to the skin, lightheadedness, and nausea.
Before receiving an ESI, people must sign a written consent due to possible safety concerns. ESIs are safe when administered by experienced professionals. The recommended maximum annual doses for four common ESIs are: betamethasone (12), dexamethasone (16), methylprednisolone (80), and triamcinolone (100).
If pain persists or worsens after an ESI, a person should contact a doctor immediately. They should also inform a healthcare professional about any side effects they experience after having an ESI. The use of multiple high doses of ESIs may cause too many risks for certain people, and side effects from ESIs often depend on the dose. It might be safer to use a moderate instead of high dose of ESI if it is still a high enough dose to manage pain.
In summary, while ESIs can be an effective means of managing chronic back and neck pain, it's crucial to understand the potential risks and considerations involved. Always consult with a licensed and experienced doctor to discuss the best treatment options for your specific condition.
- Epidural steroid injections (ESIs) may not be a long-term solution for chronic pain, as they cannot cure the underlying condition and guidelines do not specify a safe number for a lifetime.
- Mental health is an important factor to consider in managing pain, and it's crucial to inform your healthcare professional about the effectiveness of ESIs, as they use pain scales to assess medication dose and efficacy.
- In addition to pain management, maintaining a healthy lifestyle through fitness and exercise, as well as proper nutrition, can contribute to overall health-and-wellness and mental-health outcomes.
- Substance use, including opioids, can often exacerbate chronic pain and be detrimental to health, and may require therapies-and-treatments to address addiction.
- It's essential to follow safety protocols before receiving an ESI, such as signing a written consent, and to monitor for side effects, as the use of multiple high doses of ESIs may cause too many risks for certain people.
