High dosages of oral corticosteroids taken daily for prolonged periods of time can have serious systemic side effects including bone loss ( osteoporosis), increased risk of infections and diabetes and cataracts, thinning of skin, stretch marks, increased facial/body hair growth, acne, fluid retention, weight gain with redistribution of fat (fat deposits on back and face, thinning of limbs), muscle weakness, decreased resistance to infections, stomach ulcers, mood swings, insomnia, suppression of the body's own production of cortisol, etc.
The following patients should not have this injection: if you are allergic to any of the medications to be injected, if you are on a blood-thinning medication (. Coumadin, injectable Heparin), or if you have an active infection going on. With blood thinners like Coumadin, your doctor may advise you to stop this for 4-7 days beforehand or take “bridge therapy” with Lovenox prior to the procedures. Anti-platelet drugs like Plavix may have to be stopped for 5-10 days prior to the procedure. Aspirin should be stopped for cervical procedures for 10 days prior, but not for Lumbar.
Epidural steroid injections are most commonly used in situations of radicular pain, which is a radiating pain that is transmitted away from the spine by an irritated spinal nerve. Irritation of a spinal nerve in the low back ( lumbar radiculopathy ), such as from lumbar spinal stenosis , cervical spinal stenosis, herniated disc , and foraminal encroachment, causes back pain that goes down the leg. Epidural injection is also used as a minimally invasive procedure to treat nerve compression in the neck (cervical spine), referred to as cervical radiculopathy , which causes pain.