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Regenerative Medicine

What to Expect if Epidural Steroid Injections Don’t Work

By Last updated on April 26th, 2022April 26th, 2022No Comments

Millions of Americans suffer from some form of back pain on a regular basis. When pain is too much to bear, or if it is impacting daily activities, it’s time to see a medical professional.

There are many treatments available for back pain. Some of the more common treatments include posture correction, medication, and physical therapy. Another popular treatment for chronic pain is corticosteroid injections.

Many patients see positive results with these injections, but there are common side effects that should be taken into consideration when deciding on a treatment plan.

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What Are Epidural Steroid Injections?

The epidural space in the spine exists inside the vertebral wall and surrounds another membrane called the dura mater.

It contains veins, nerve roots, fat, connective tissue, and many more vital components. The purpose of the epidural space is to protect these components. It also provides extra room for the spine to move around and absorbs shock.

Space surrounding the spine is meant for protection, but this tissue can become inflamed and place stress on nerves. Compressed nerves can lead to pain in the back, pain or numbness in the extremities, and a tingling sensation depending on where the compression has occurred.

Some other symptoms may be associated with the condition, so it is important to discuss any potential symptoms with a doctor, even if they seem irrelevant.

Cortisol is a hormone that is released naturally by the body. Blood sugar levels, inflammation, and metabolism can all be affected by cortisol levels. Epidural steroid injections contain a synthetic form of cortisol called cortisone. An increased amount of cortisol can reduce swelling and therefore pain associated with the injury.

During epidural steroid injections, doctors use an X-Ray or other imaging technology to ensure that the needle is placed in the correct location that will reduce the most inflammation. Many injections also include a local anesthetic to reduce the pain that may occur as the injection is happening. The location of the injection depends on where the pain is located and can occur in the upper (cervical), middle (thoracic), or lower (lumbar) portions of the spine.

Conditions That May Be Treated With Epidural Steroid Injections

Treating back pain can be difficult, as the spine and the nerves inside can be delicate. Due to the complex nature of nerves and the space surrounding them, many symptoms do not present as just pain. Other possible symptoms of a back injury include:

  • Pain in hands or feet
  • Pain that radiates down the arms or legs
  • Numbness
  • Tingling sensation
  • Muscle spasms

Steroid injections can be used to treat pain throughout the body. Patients with chronic joint pain often consider this form of treatment for pain relief as well as patients with back pain. These injections are often coupled with other treatments such as physical therapy and medication.

Conditions of the spine that may be treated with steroid injections include:

  • Spinal stenosis: the spinal canal can narrow and create pressure on nerves and the spinal cord. This may result in pain, numbness, tingling, or weakness.
  • Herniated or “slipped disc”: discs are a piece of cartilage that exist between the bony vertebrae in the spine. Discs work to absorb shock, help with flexibility, and reduce the likelihood that bones will rub against one another. With a herniated disc, the inner gel material, known as the nucleus pulposus, seeps out of the disc and onto the spinal nerves, producing pain and numbness in the back and/or extremities.
  • Spondylolisthesis: vertebrae can slip out of place, which may, in turn, apply pressure to the spinal canal. The condition may cause pain and other nerve-related symptoms such as tingling or numbness.
  • Bone spurs: extra growth on bones is another condition that may lead to pain and inflammation.

There are many ways in which a doctor may diagnose and treat these conditions, depending on the individual patient’s needs. Any condition that involves inflammation causing nerve compression may benefit from these injections. Due to the potential side effects, some conditions such as high blood pressure or diabetes may impact a doctor’s decision to use them.

Risks of Steroid Injections and Why They May Not Work

Risks of Steroid Injections and Why They May Not Work

Epidural steroid injections have been used to treat pain for decades. Recent findings, however, have proven that there are potentially harmful components to the injections.

Repeated treatment via steroids can impact the body in many different ways. As a general rule, physicians try to minimize the use of steroids. Some of the most common side effects can include those which are typical of many steroid treatments:

  • Irritability
  • Anxiety
  • Restlessness
  • Allergic reaction
  • Increased pain
  • Bleeding
  • High blood sugar
  • Headaches

It is important to maintain an open line of communication with doctors, as other symptoms may also occur. Repeated injections can deteriorate soft tissue over time. For this reason, many practitioners place a limit on the number of injections they will perform. This treatment is not advised for a long-term solution as it does not treat the underlying issue.

Epidural steroid injections may not deliver the expected results. Doctors can often recommend other options that may relieve pain, though these come with their own risks – they may prescribe opioids, a highly addictive pain medication, for example.

Back surgery is rare, but some patients may face a surgical option if all other conventional treatments have failed. Some alternative treatments offer medical solutions which can render surgery unnecessary. Such treatments include regenerative medicine therapy.

Some patients have opted to explore regenerative medicine to avoid severe side effects and a decline in their medical condition.

Regenerative Therapy Treatments for Back Pain

Reduced pain can lead to more involved physical therapy, greater enjoyment of life, and the ability to return to tasks that weren’t possible due to symptoms.

There may be an option that offers not only pain relief, but the treatment for the underlying condition as well. The field of regenerative medicine seeks to use the body’s own naturally occurring healing cells to enhance the recovery process. CELLAXYS offers two types of regenerative therapy:

  • Mesenchymal stem cell therapy: mesenchymal stem cells are located throughout the body, and contain the ability to help cells regenerate once they have been damaged. Cells are procured from the bone marrow. The cells are then processed and injected into the area where the pain is most prevalent. Increasing the amount of regenerating cells can help damaged cells recover while simultaneously reducing pain.
  • Platelet-rich plasma (PRP) therapy: whole blood contains many important components, one of which is called platelets. These cells contain proteins and 10 different healing factors that can reduce inflammation. Platelets also signal other healing cells, such as mesenchymal stem cells and fibroblasts, adding to their benefits in spine procedures. The procedure of receiving PRP therapy is similar to that of mesenchymal stem cell therapy. Once blood is drawn from the patient it is placed in a centrifuge that helps to concentrate the platelets. The concentrated PRP solution is then injected into the problem area.

Both forms of regenerative medicine involve outpatient appointments that usually take under two hours. The most common side effect is some pain around the injection site. As these treatments are utilizing a patient’s own cells, the risk of rejection, allergic reactions, and other adverse effects is significantly reduced.

Doctors use imaging techniques such as ultrasound or an MRI to locate the exact point where the needle should be entered prior to our procedures. Our procedures are always performed under live X-ray called fluoroscopy.

These therapies have seen significant positive results and continue to be a viable option for chronic pain sufferers. Unlike some conventional treatment methods, regenerative medicine seeks to reduce pain and simultaneously treat the underlying cause. Some patients are even able to avoid surgery or other intrusive treatment methods.

Dr. Pouya Mohajer

Director of Regenerative Interventional Spine Medicine
Board certification in Anesthesiology and Interventional Pain Medicine
Fellowship-trained from Harvard University
UCLA Alumni

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