Almost everyone has had an aching back or nagging next pain at some time. Most commonly, this can be from an injury or from arthritis. Most of the time the pain is temporary or may come and go. It may be helped significantly by anti-inflammatory medicine such as Mortrin or Aleve. It may be relieved by heat or ice. Short periods of rest may be helpful. Physical therapy or chiropractic care may also be beneficial.

However, at times none of these treatments is helpful. For example, may people have persistent neck and shoulder pain or even numbness down the arm into the fingers. There may be accompanying headache in the back of the neck. Other people may have persistent lower back pain, sometimes with pain or “pins and needles” down one or both legs.

In these cases, epidural steroid injections may be of great benefit.

In this procedure, a thin needle is placed in the neck or back into the area surrounding the nerves and other structures of the spine. Next, a steroid medicine such as Depo-Medrol is injected through the needle and into the epidural space. The procedure is done under X-ray guidance to make sure the medicine gets to the right place. Since the steroid is an anti-inflammatory drug, it bathes the nerves and surrounding structures to remove the inflammation. This results in pain relief.

Often, the relief is dramatic. Many times one injection is sufficient but at other times, two or three injections given weekly or every other week may be most helpful.

The procedure can be done in just a few minutes. Most people can resume their normal activities the same day as the injection, though it may take several days to feel the benefit from the medicine.

In summary, epidural injections are worth considering in the treatment of neck and back pain that is not responding to other modes of treatment.

Dr. Norman M. Krause, M.D., is an orthopedic surgeon at Auburn Memorial Hospital.