What are the indications for epidural injections

Epidural steroid injections have been shown to be effective in treatment of radicular symptoms due to disc herniation, central spinal stenosis, and neuroforaminal stenosis. Limited evidence supports the role of epidural injections for axial pain. Axial pain subgroups, such as those with annular tears or disc end-plate inflammatory changes, are considered more likely to benefit from epidural steroids than patients with nonspecific axial pain. Limited evidence supports efficacy of injections for ongoing radicular and/or axial pain following prior spine surgery.

Injections are indicated when pain is refractory to less invasive treatments, such as physical therapy and medication. Repeat injections are indicated in patients with partial relief of symptoms after the initial injection. Many practitioners limit the number of epidural injections to three per year to minimize the side effects from repeated corticosteroid injections. Each practitioner is advised to weigh the risks and the benefits before proceeding with each injection.

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