Question: How effective are epidural treatments in treating upper back pain? I have an arthritic disc in my neck, and suffer from upper back pain and discomfort. I think the degenerated disc is pinching the nerve.
Dr. Hibberd's Answer:
Epidural treatments may be an effective pain-management technique of acutely prolapsed discs combined with additional treatment. The epidural treatments are actually simple local injections of medication (usually cortisone) into the space around the outside of the spinal cord, and have minimal risk in experienced hands.
The epidural space has been found to be a relatively safe place to insert medications for the relief of pain. In fact, many women elect epidural anesthesia (a local anesthetic is used) during childbirth. The procedure provides great pain relief and enables a much more comfortable birthing experience.
The only caution is that these epidural treatments will only buy time for the natural healing to occur. There is no evidence to support the often-presumed notion that epidural treatments hasten healing. Though they do not actually speed up the clearance of the disc prolapse, they do enable those who are uncomfortable to become more active and functional with less pain and earlier mobilization.
Though often also used for chronic pain management, sometimes the immobility caused by chronic pain causes its own disability, and treatments such as epidurals have the potential to offer a reprieve in back discomfort so additional therapy can proceed.
The ultimate aim is to return to normal function as soon as possible without the need to resort to sometimes risky surgical management.
Arthritic disease often needs aggressive management, especially when nerve-root compression is involved, and each case needs to be considered on its individual merits by your orthopedic or neurosurgeon. Sometimes epidural treatments may offer a window of time for recovery and healing, but they should be regarded as a means to relieve pain, not as curative procedures.
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