Information on the Epidural shot

So just what is an Epidural shot. There is a group of Doctors who have carved out a nice "little niche" for themselves called Pain Management Specialists. What they do primarily, is inject steroids and other pain medicine into the epidural which is the outer layer of the spinal cord depicted in green in the photo to the left. Most of them like to do a series of 3 shots to the tune of about $2,000-$2,500 dollars. If this procedure gives any relief at all, it is for about 2 weeks. Most of these doctors are anesthesiologists and while a few of them will work with you with powerful pain medications, the majority send you back to your primary care physician for him to prescribe them to you. I know because I have been through it. The ones that only want to do the epidural shots are called "procedure mills".

They use the excuse that you might become addicted. First of all, they don't even have their terminology right. The correct word is "chemical dependency" which is a normal occurrence with opiates. If someone wants to continue taking these drugs after they no longer need them, or just try to get them for the so-called high, then they are addicts. Surveys have indicated that only 1% to 3% of chronic pain patients ever get addicted. To get off of these drugs, all you do is slowly reduce your dosage until you are off of them. I have done it 15 to 20 times myself. It is a hell of a lot easier to get off of opiates than getting off of nicotine. I can also say that from personal experience.

The epidural marked in green, looking down on a disc showing the spinal cord in the center where the blue dot is and the green is the epidural or the outer wall of the spinal cord. The other clusters are nerves that come out of the spinal cord and go to places all over your body. You will understand better if you read what Dr Burton has to say. Then go to his website to read the entire article. If you want to learn now is the time, especially if you have back problems like I do.
According to him the spinal cord is the most fragile, yet the most abused part of the human body.

http://www.burtonreport.com/InfSpine/EpiduralSteroidAnatomy.htm with the permission Of Dr. Charles V. Burton, a board certified neurosurgeon, who is the top spine surgeon in the USA. If you have any kind of spinal problems you need to go to his site, http://www.burtonreport.com/ .

"The epidural space is an anatomic structure that surrounds the dura mater within the spinal canal and extends to the brain itself. In some areas it is a real space and in others only a potential space. The space itself consists of fat and blood vessels. Its importance is based on the fact that many physicians have selected this site as a depository for injected medications as a treatment for low back pain.

The illustration to the left represents a post-mortem axial section of a normal lumbar spinal canal. The vertebral body is shown at the top and the lamina of the vertebrae at the bottom. The epidural space surrounds the dural membrane. Only the posterior portion of the epidural space is outlined in green as this is the area of clinical interest.

The blue dot has been inserted intracathecally, that is, within the subarachnoid space. The subarachnoid space is one of the most fragile, delicate and sensitive areas of the human body. This space contains the brain, spinal cord and nerve roots of the cauda equina. It is filled with cerebro-spinal fluid which acts to support and nourish the nervous system. The subarachnoid space is very sensitive to insult while the epidural space is very resistant to insult. Unfortunately they are separated by only a thin membrane, the dura mater lined by an even thinner membrane, the arachnoid membrane.

In this diagram the site of the epidural space is highlighted with a green dot (which lies on the dura). In this representation the dura and the underlying arachnoid membrane are both shown. Note that the epidural space is separated from the subarachnoid space by only these thin membranes. When a needle is used to deposit substances, such as steroids, in the epidural space the procedurist (physician performing the injection) has the responsibility of accurately placing the material in the epidural space because only a slight inaccuracy permits the steroid entry into the subarachnoid space thus introducing the risk of adhesive arachnoiditis ".

Go to Dr. Burtons website to see the rest of his article.