HERNIATED DISC

Intervertebral discs lie between vertebrae in the spine and consist of several layers of strong fibrocartilage (annulus fibrosis), surrounding a nucleus of loose fibers suspended in a jelly-like substance (nucleus pulposis). This nucleus acts as a shock absorber, absorbing the impact of the body's daily activities and keeping the two vertebrae separated. If there is a tear in the annulus fibrosis, then the soft gel of the nuclus pulposis will be forced out and may put pressure on the nerve located near the disc. The herniated disc presses against nerves, causing radiating pain, numbness, tingling and diminished strength in an extremity. The gel also contains inflammatory proteins that can cause pain.

Treatment

An epidural steroid injection is often used to help alleviate the symptoms of a herniated disc. There are three different approaches and the approach varies based on your symptoms, EMG/NCS findings and MRI findings. Performed in an operating room under sterile conditions, a small needle is inserted under X-ray guidance, and both steroid and anesthetic are injected into the epidural space above the spine. The steroid decreases swelling and chemical irritation of the nerves, reducing pain and allowing for increased activity and exercise.

These injections can be slightly painful, so every effort will be made to minimize your discomfort. Please discuss any concerns with your doctor before beginning the treatment. The doctor will also discuss the risks, benefits and alternatives to this procedure..

Typically, patients are sore for 24 hours after an epidural steroid injection. By the third day after the procedure, patients usually start to notice decreased pain. In many cases, more than one injection may be required in a three- to four-month period to adequately reduce pain. Approximately 50 percent of patients who receive injections have good long-term results and do not require surgery.

Within 72 hours of the procedure, stop taking aspirin, anti-inflammatory medication (Motrin, Advil, Aleve, ibuprofen, Celebrex, Naprosyn, naproxen, ketoprofen, Feldene, Indocin, Relafen, Mobic), and blood thinners (Coumadin, Aggrenox, Plavix, heparin, Lovenox). Please let your doctor know if you have an allergy to iodine or shellfish before undergoing treatment.