An epidural injection is not quite the same as what pregnant women use for anesthesia during childbirth.  Epidural refers to the location in the spine in which the injection is taking place.  The nerves that travel through the spine are enveloped by three layers, the most superficial of which is the dura.  “Epidural” means above or over the dura.  The only thing child delivery anesthesia and epidural pain injections have in common is that they occur in the epidural space of the spine.

Here is a little information on epidural injections for back pain, including just how many of these injections are recommended:

  • An epidural injection involves placing a needle through the skin and advancing it to the superficial epidural space (this is superficial, not deep within the spine). A combination of anesthetics and anti-inflammatory medications are then injected.
  • Epidural injections are very effective in treating neck and back pain from pinched nerves.
  • How many do you need to have? The answer is as few as possible.  There is not one single professional medical organization that advocates performing multiple injections on patients off the bat.
  • The most reasonable course of action is to have one injection and see how you do. If the injection does not help there is no point in repeating it.  Your doctor should look elsewhere to find pain relief for you. 
  • If the injection provides significant relief lasting 2-6 weeks and you’d like another injection, that’s reasonable.
  • Every single spine professional organization cautions against more than 2 injections per injury or flare up. The reason is that the medications used in epidural injections are relatively benign, unless they are administered repeatedly.  Too many injections can cause significant side effects like immunosuppression, thinning of bones and elevated blood sugar levels. 
  • Bear in mind that neck and low back pain usually come from separate injuries. Therefore, it’s reasonable to have a neck epidural injection and a low back epidural injection.  Follow the advice above to determine whether or not you should have either injection repeated.
  • So, what should you do if your doctor says you need 3 epidural injections for your neck and 3 for your back? The short answer is to take a pass and look for a new spine specialist.  Your doctor has recommended therapy that is contrary to medical guidelines and may have serious side effects.