Monthly Archives: June 2015

Does the Epidural always work for Pain?

 

When Do Epidural Steroid Injections Work for Back Pain?

by: Sylvia Marten  spine-health.com

For most people suffering from back pain, surgery is scheduled only after all other options have been exhausted.

One non-surgical approach to pain relief is epidural steroid injections. They are only intended for temporary pain relief, but steroid injections coupled with therapeutic exercise may allow patients to postpone or even avoid surgery altogether.

Epidural injections deliver steroid medication directly to the source of pain.

Epidural steroid injections are most often used to treat low back and leg pain associated with sciatica, which is pain caused by a pinched nerve in the low back that radiates down the leg.

  • Sciatica can result from a number of conditions, including a herniated disc, degenerative disc disease, or spinal stenosis.

Epidural Steroid Injections Video

Many Spine-health readers have had epidural steroid injections and have shared their results with us:

  • There were many people who did experience relief, if only temporarily.
  • In several instances, injections helped our readers reduce their pain while they waited for their scheduled surgery.
  • There was also indication among our readers that a series of 3-4 shots provided the most relief, while anything more than that had little effect, or even made pain worse.
  • A select few were awarded complete relief and were able to return to normal activities.
  • For as many of our readers who have had success, there were just as many who experienced little to no relief from epidural steroid injections.

Fluoroscopy, or live X-ray, has been shown to be the most effective way to deliver the medication most accurately to the epidural space.

The most common reader complaints were centered on the side effects associated with steroids. Many reported significant weight gain and bloating, swelling of the face, feet and ankles, and headache and nausea.

Another concern for some readers, especially those with diabetes, was the rise in blood sugar associated with steroids.

Efficacy of epidural steroid injections

There is no conclusive evidence that epidural steroid injections work better for one condition than another. Success rates are different for each individual. For those hoping to postpone surgery, injections may provide enough temporary relief.

Steroid injections may also effect enough pain relief to allow you to begin a physical exercise program. Many people have gained enough pain relief through an exercise program to avoid surgery.

The most important thing is to find a doctor that you trust, and who will adequately answer any questions you may have regarding your condition or the injection procedure.

 

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Blue Ridge Orthopaedic & Spine Center has on-site state-of-the-art technology to diagnosis and treat orthopaedic conditions. Both of our offices are equipped with in-office  radiology departments. Not only does this facilitate rapid diagnosis but it is also convenient for patients who may be experiencing pain or disability at the time of their visit. To schedule an appointment with one of our board-certified and fellowship trained physicians, call our Warrenton office at 540-347-9220 or our Gainesville office at 703-743-2814.

Stiff Neck Causes and Symptoms

Stiff Neck Causes, Symptoms and Treatment
Richard A. Staehler, MD, www.spine-health.com

A stiff neck is typically characterized by soreness and difficulty moving the neck, especially when trying to turn the head to the side. A stiff neck may also be accompanied by a headache, neck pain, shoulder pain and/or arm pain, and cause the individual to turn the entire body as opposed to the neck when trying to look sideways or backwards.

Symptoms typically last for a couple of days or a week and may prompt neck pain that ranges from mildly painful but annoying to extremely painful and limiting. While there are a few instances in which neck stiffness is a sign of a serious medical condition, most episodes of acute neck stiffness or pain heal quickly due to the durable and recuperative nature of the cervical spine.

Neck Strains and Sprains Video

The most common causes of a stiff neck include, but are not limited to, the following:

Muscle Strain or Sprain
By far the most common cause of a stiff neck is a muscle sprain or muscle strain, particularly to the levator scapula muscle. Located at the back and side of the neck, the levator scapula muscle connects the cervical spine (the neck) with the shoulder. This muscle is controlled by the third and fourth cervical nerves (C3, C4).

The levator scapula muscle may be strained or sprained throughout the course of many common, everyday activities, such as:

  • Sleeping in a position that strains the neck muscles
  • Sports injuries that strain the neck
  • Any activity that involves repeatedly turning the head from side to side, such as swimming the front crawl stroke
  • Poor posture, such as slouching while viewing the computer monitor
  • Excessive stress, which can lead to tension in the neck
  • Holding the neck in an abnormal position for a long period, such as cradling a phone between the neck and shoulder.

Meningitis / Infection
A stiff neck, in conjunction with a high fever, headache, nausea or vomiting, sleepiness and other symptoms, may be indicative of meningitis, a bacterial inflection that causes the protective membranes of the brain and spinal cord to be inflamed. Other infections can also cause stiff neck symptoms, such as meningococcal disease, an infection in the cervical spine. Any time a stiff neck is accompanied by a fever, it is advisable to seek immediate medical attention to check for these possibilities.

Cervical Spine Disorders
Many problems in the cervical spine can lead to neck stiffness. The stiffness can be a reaction to the underlying disorder in the cervical spine. For example, a cervical herniated disc or cervical osteoarthritis can lead to neck stiffness, as the structures and nerve pathways in the cervical spine are all interconnected and a problem in any one area can lead to muscle spasm and/or muscle stiffness.

Stiff Neck Treatment

As a general rule, it is advisable to seek medical attention if the stiff neck symptoms do not subside after one week. Immediate medical attention is recommended if neck stiffness is noted after a traumatic injury, or if there are additional troublesome symptoms, such as a high fever.

In the vast majority of cases, a stiff neck may be treated within a few days.

 

 

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Blue Ridge Orthopaedic & Spine Center has on-site state-of-the-art technology to diagnosis and treat orthopaedic conditions. Both of our offices are equipped with in-office  radiology departments. Not only does this facilitate rapid diagnosis but it is also convenient for patients who may be experiencing pain or disability at the time of their visit. To schedule an appointment with one of our board-certified and fellowship trained physicians, call our Warrenton office at 540-347-9220 or our Gainesville office at 703-743-2814.

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