What is an epidural

This procedure is named after the space into which the medicines are injected. The epidural space surrounds the spinal fluid space. The nerves, after leaving the spinal cord, have top (delete) cross the epidural space on their way to the legs. The epidural space is normally empty but is an ideal place to introduce medications that can act upon nerves.

What about X-ray?

If Epidurals are performed "blind", that is without the use of X-ray have been shown to end up in the wrong place 60% of the time even in expert hands

How effective are epidurals?

Epidurals have traditionally been used to treat many sources of chronic pain. Unfortunately, epidurals are not as effective in treating a number of these conditions as previously believed. I am going to deal with each of these conditions below:

Back Pain

There is no research literature to support the use of epidurals for ordinary back pain. Certainly, transient relief from the local anesthetic is commonplace, but long term benefit has never been proven. Steroids are also injected and these can be harmful in a number of ways.

Leg pain

Irritated, pinched or trapped nerves running to the leg certainly can benefit from epidurals. Currently, the research shows that a special kind of epidural - a transforaminal epidural is more effective. As a result I usually perform transforaminal epidurals for leg pain.

Spinal stenosis

In this condition, the spinal canal is very tight and squashes a number of the nerves to the legs. In this situation, it is my experience that patients frequently get benefit with epidural injections, both for their back and leg pain.