Corticosteroids for Spinal Cord Injury
Corticosteroids have strong anti-inflammatory properties which help to relieve painful pressure on the spine.
In some cases, other treatments fail to bring relief from pain. In this case, a spinal injection may offer temporary relief from chronic pain. This treatment delivers corticosteroids by means of a needle into the tissue surrounding the spine (perineural area), reducing inflammation and, therefore, pain.
A spinal injection may also be useful in diagnosing whether a specific site or region in the spine is the source of chronic pain. It can also provide short-term relief of pain by reducing swelling.
Epidural Steroid Injection
The type of spinal injection delivers the medicine into the epidural (outermost part of the spinal canal) and perineural areas of the spine by one of three routes:
- Caudal: this technique is often used when fluoroscopic (X-ray) guidance is not available, and is favored for lower lumbar and sacral areas
- Translaminar: this technique delivers the medicine very closely to the spine
- Transforaminal: this technique, used with fluoroscopic guidance, allows precision placement of the needle
After your doctor performs a physical exam and does the appropriate diagnostic imagining (as necessary, such as an X-ray, magnetic resonance imaging [MRI] or computed tomography [CT] scan), they will give you a sedative and/or a local anesthetic to help alleviate pain and relieve anxiety. You will remain conscious for the procedure, which will last about two to three hours, with one hour for the procedure itself.
Your doctor will have you lie on your side on an X-ray table, and the skin on your back will be carefully washed with a sterile solution. A syringe that contains the corticosteroid as well as the local anesthetic will be injected into the problem area near the spine.
The X-ray table will allow careful imaging that helps guide placement of the needle. In some cases, contrast material may be injected as well, to better-indicate the position of the needle, to ensure precise delivery of the corticosteroid. Once delivered, the needle will be removed and a small bandage placed at the site of the injection.
You will spend time in the recovery area, where you will be monitored, and because you were sedated, you will need someone to drive you home. Once you get home, you should:
- Rest for the remainder of the day
- Avoid baths, pools, or whirlpools for 24 to 48 hours
- Apply ice (as needed) to the injection site
The corticosteroid may take up to a few days or a week to reduce inflammation and bring relief from pain.
While uncommon, complications may occur from a spinal injection. These may include:
- Dural puncture
- Vasovagal reaction (for example, change in blood pressure or fainting)
- Intravenous injection (fluoroscopy helps prevent this)