Adverse Effects from Epidural Steroid Injections

Epidural steroid injections have become a mainstay of treating herniated discs (sciatica).  As a interventional pain specialist I’ve seen them work well to avoid surgery hundreds of times. However, there can be adverse effects from epidural steroid injections.  These side effects are generally much less than surgery.  The side effects from epidural steroid injections can be: increased pain or numbness, an increase in epidural fat causing pressure on the nerve, immune and repair function suppression, just to name a few.  In our clinic, we consider that the most concerning of these side effects of epidural spinal shots for pain are caused by the extremely high doses of steroids commonly used.  Steroids are a two edged sword (like cortisone). They do bring down swelling around the nerve.  However, for an unknown reason (likely due to medical tradition and certainly not medical science), most physicians use about a million times more steroid than your body uses on a day to day basis.  We’ve found that lowering the dose of steroids from the milligram range to the nano-gram range doesn’t diminish the anti-inflammatory effect, just the side effects.  This is because your body naturally produces it’s own steroids in nano-grams (one billionth of a gram) and not milligrams (one thousandth of a gram).  We also commonly add in platelet lysate (growth factors isolated from the patients blood and processed in a our cell culture lab).  These growth factors (especially VEGF) can help bring in much needed extra blood supply to the poorly vascularized and nutritionally challenged disc, helping the disc heal itself.  We can also create a VEGF rich supernatant (we call it super VEG) by culturing the patient’s blood platelets.  What if the disc/nerve (sciatica) problem still persists?  We then turn to using the patient’s own stem cells to heal the tears in the disc and get rid of the bulge.  For more information, click the link in the last sentence or check out the video below:

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