Thankfully, medical advancements have resulted in minimally invasive procedures for many back problems. Spinal stenosis, for example, can be treated using minimally invasive laminectomy, where parts of the vertebra are removed to relieve pressure on the nerves. “Some patients suffering from herniated disc can also be treated through disc nucleoplasty,” Dr Tow explains, “where a special radio-frequency ablation needle is used to decrease the internal pressure in the disc, decreasing the impingement on the nerves and spinal cord.” In the case of disc nucleoplasty, it can even be just as fast as the epidural injection.
How often cortisone injections are given varies based on the reason for the injection. This is determined on a case-by-case basis by the health care practitioner. If a single cortisone injection is curative, then further injections are unnecessary. Sometimes, a series of injections might be necessary; for example, cortisone injections for a trigger finger may be given every three weeks, to a maximum of three times in one affected finger. In other instances, such as knee osteoarthritis, a second cortisone injection may be given approximately three months after the first injection, but the injections are not generally continued on a regular basis.
Cervical Epidural Steroid Injections involve injecting a steroid into the epidural space of the cervical spinal canal where irritated nerve roots are located. The injected medications include both a long-lasting steroid and a local anesthetic (Lidocaine, Bupivacaine).
The steroid reduces inflammation and irritation, while the anesthetic interrupts the pain-spasm cycle and nociceptor transmission (Boswell 2007). The medicines spread to the most painful levels of the spine, reducing inflammation and irritation. The entire procedure usually takes less than 15 minutes.