Will an Epidural Injection Reduce My Lower Back Pain?

You may have heard about epidural injections as a treatment for low back pain. Have you ever wondered what that involves or whether it may be the right treatment for you?

The skilled pain management clinicians at Florida Pain Medicine want you to understand what epidural injections are when they should be used, and who should use them.

What are epidural injections?

Epidural injections commonly referred to as ESIs — for epidural steroid injections — can treat common back conditions like spinal stenosis, spondylolysis, or disc herniation. During the procedure, your practitioner places a hollow needle into the space between your spinal nerves and bones to deliver anti-inflammatory medicine.

The injection doesn’t cure your back pain, but it helps alleviate your symptoms, including inflammation. After the injection, you may be able to participate in therapy and home exercises, which can further help to improve your back condition.

Who may benefit?

Epidural injections can address a variety of painful conditions in your lower back. Our team sits down with you to discuss your past treatment, review your medical history, and create a treatment plan that works best for you.

Here are a few of the conditions that epidural injections can help:

Lumbar disc herniation

This condition is commonly called a slipped disc. Your spine is made up of many bones, and you have discs between the bones to keep them from rubbing against one another. The discs are soft and rubbery inside and surrounded by a tougher substance on the outside.

When a disc herniates or slips, the softer center pushes out through a tear in the tougher outer portion. This slipping of the soft part of the disc can cause pain, weakness, or numbness on one side of your body and down your leg. Sometimes, you may have a herniated disc and have no symptoms.

Lumbar spinal stenosis

“Stenosis” means abnormal narrowing. Spinal stenosis means you have a narrowing of the space in between your spinal nerves and the bones of your spine. You may have been born with this condition, but it’s most often due to normal aging.

Spinal stenosis can cause pain and symptoms of sciatica — weakness in the lower back and legs, tingling and numbness that can start in your low back and travel to your buttocks and legs. This pain can worsen with activity.

Annular tear

The outside of spinal discs is made up of ligaments that overlap, known as annulus fibrosus. This tough exterior protects the softer inside part of the disc, but it also allows you to move, twist, and bend without injuring the disc. If the annulus fibrosus weakens, it can tear, which causes pain in your lower back.  

Degenerative disc disease

A common reason for lower back pain is degenerative disc disease. This condition is caused by normal wear and tear on the discs in your spine. It can cause shooting pain, numbness, and weakness in your legs. You may feel a constant low ache or pain with this back problem but also have episodes of severe, shooting pain.

Who should not get an epidural injection?

Specific treatments are not appropriate in every case. Some of the reasons that would keep you from having a steroid epidural injection include:

  • Infections: local or throughout your body
  • Bleeding: conditions such as hemophilia or if you are taking blood thinners that can’t be stopped for the procedure
  • Pregnancy: if fluoroscopy (X-ray) is used to aid in administering the injection

If you are ready to talk to one of our Chandler Pain Management doctors about epidural injections and other treatment options for your low back pain, call or click for an appointment at one of our four convenient locations.

9 Treatments That Could Help Chronic Back Pain

9 back pain treatments that could help reduce chronic pain

The twin goals of back pain treatments are to relieve symptoms and improve your daily life. There are a variety of treatment options that range from conservative approaches to surgery if pain persists. For most patients, conservative treatments will help them relieve their pain and get back to their lives.

Here are nine back pain treatments that could help.

Acupuncture and chiropractic care

Acupuncture is gaining traction as a research-based treatment of back pain.

And speaking of traction, chiropractic care offers spinal adjustments that can offer significant relief and improved function.

Non-steroidal anti-inflammatory drugs (NSAIDs)

Pain-relieving medications are the initial treatment of choice for acute back pain. These can include over-the-counter pain medicines such as acetaminophen and ibuprofen.

For many, taking these in conjunction with a therapy like physical therapy or chiropractic care can help you get the treatment you need with less pain.

Prescription medications

Muscle relaxants can also help ease back spasm and tension for some patients.

In general, opioids are ineffective for long-term management of back pain but may be recommended during the acute phase.


Some types of injections can be helpful to manage back and address its causes, including epidural steroid injections.

Learn more about this treatment approach in the following video.


Rest is suggested only in the most acute phase of back pain, usually three days or fewer. Too much rest can make pain worse.

Lifestyle changes

All people will likely benefit from making adjustments to diet and activity to help facilitate weight loss or to help maintain a healthy body-mass index (BMI).


Most back pain will resolve itself within a few weeks, and exercise can help make this happen. Core exercises and low-impact whole body workouts like swimming and yoga help strengthen the body.

Physical therapy

Physical therapy uses individualized exercises to improve range of motion, increase flexibility, and speed recovery of both acute and chronic back pain.

This is a great first-line treatment for many more moderate to severe cases of back pain.


Can Medical Marijuana help Back pain

Back Pain Statistics

According to the American Chiropractic Association:

  • In U.S. around 31,000,000 people suffer from lower back pain at any given time.

  • Annually, half of all working Americans suffer from back pain symptoms.

  • 80% of the US population suffer from back pain at some point their lives.

The Bone and Joint Initiative reveals:

  • The combined cost of lost work and treatment of back pain in the U.S. is approximately $253 billion annually.

  • About 10% of all visits to hospitals and emergency rooms are related to back and neck pain.

These statistics on back pain reveal how common a condition a spinal injury is and the impact it has on individuals and society as a whole. In industrial countries, 60 -70% of people will suffer from back pain at some point in the life.

Causes of back pain include:

  • Simple spain and/or strain

  • Sciatica

  • Ruptured disc

  • Osteoporosis

  • Arthritis

  • Bulging disc

  • Scoliosis

Conventional treatments for these conditions are medications such as anti-inflammatories, pills for treat nerve pain, and addictive medications such as narcotics, antidepressants and injection therapy. From time to time patient will end up with surgery, which can cause problems later. Today, many people are turning to medical marijuana to treated their back pain.

How Is Medical Marijuana an Effective Treatment for Back Pain?

Medical cannabis can be an alternative to traditional treatments. It is becoming an increasingly preferred treatment for patients with chronic back pain. For example, conventional medications can cause a multitude of side effects like nausea, stomach upset, ulcers and gastric bleeding. Medical marijuana does not have the same associated side effects. Here are some ways with medical marijuana can help treat back pain:

  • It may reduce your pain to a level where you can live an active life

  • It may allow you to be free from potentially dangerous and addictive medications, while having an overall better quality of life.

  • Chronic back pain can cause depression, insomnia and anxiety. Medical marijuana can eliminate or reduce many of these symptoms.

  • It is natural substance from plant, without chemicals,.

During a study conducted at the University of Colorado, they looked at 200 patients with back pain. The pain was due to conditions focused on degenerative changes. 89% of patients said medical marijuana reduced their pain moderately. 81% claimed that it worked better than narcotic medications. The consumption of medical marijuana by the patients was once or twice a day.

What Type of Back Pain Symptoms Are Treated by Medical Marijuana?

Medical marijuana can help alleviate many symptoms of back pain as there are wide range of symptoms with back pain. Here are some of the symptoms medical marijuana can help alleviate:

1. Pain and Muscle Spasms

Marijuana can help reduce muscle spasms. Some studies have reported a 45% reduction in the intensity of pain within 20 minutes of inhalation. And it is particularly effective in treating back spasms. Many states have approved the use of medical marijuana for muscle spasms. In Pennsylvania medical marijuana is approved for:

  • Severe chronic or intractable pain of neuropathic origin

  • Severe chronic or intractable pain

2. Nausea and Vomiting

One of the properties for marijuana is to reduce nausea and vomiting. Traditional medications prescribed for back pain and chronic conditions are opioids and similar drugs. These have side effects of nausea and vomiting. Because marijuana treats both nausea and pain, many patients prefer the marijuana to other drugs. Furthermore, chronic pain can cause depression. Medical marijuana, on the other hand, can creduce depression and improve sleep.

Many states have approved medical marijuana to treat nausea and vomiting. In fact, marijuana has been used among the cancer patient population for a number of years to enhance appetite and as an antiemetic, reducing side effects of chemotherapy.

3. Inflammation

Marijuana has strong anti-inflammatory properties. It is a natural substance to treat inflammation from arthritis, as well as degenerative changes in the lumbar, cervical or thoracic spine. Most back or neck pain occurs due to degenerative changes in the spine. Many patients prefer marijuana to treat their pain due to the inflammation.

Ways to Use Medical Marijuana for Back Pain

Marijuana can be used topically or internally. Some of the best methods using marijuana are as follows:

  • Inhalation: This method is smoking or vaping the weed. This produces the fastest affect, within 1-2 minutes

  • Raw juice: One can use marijuana as dietary supplement through juicing. This will reduce the pain without a psychoactive effect.

  • Tinctures: Tinctures are usually placed under the tongue and swallowed. This produces a quicker result, due to absorption through the mucosal membranes.

  • Edibles: Edible marijuana will produce a slower response because absorption needs to transfer through the gut. But, it may last longer in terms of relief and produce a better psychotropic effect. Relief may take up to an hour before one feels the effect.

  • Topicals: Topical marijuana produces a different effect. Absorption is localized to the site of the injury. One can ramp up the use based upon the desired effect.

Strains of Marijuana Used for Back Pain

Marijuana has many different strains, and they worked differently for different people and varying symptoms. Heavy THC strains seem to work best at relieving pain, whereas CBD works best for relieving inflammation. However, heavy THC causes more psychoactive effects. Patients may want to use a low THC/high CBD combination during the daytime, to remain more functional, but high THC/low CBD at nighttime, for a better night sleep.

Here are some of the strains of medical cannabis which may help to reduce back pain:

  • Bubba Kush (indica): This strain contains up to 22 percent THC and up to 0.1 percent CBD. It is good for decreasing stress and decreasing muscle spasms.

  • Candyland (sativa): With around 24 percent of THC and one percent of CBD and CBN. Candyland is good for reducing muscle spasms and tension, to reduce pain. It does have a stimulating effect, so it also helps with fatigue.

  • OG Kush (indica): Contains up to 23 percent THC and around one percent CBD. Indica is a better strain to reduce muscle spasm while providing pain relief.

  • ACDC (sativa): Sativa is high in CBD but low in THC. It contains up to 24 percent CBD and around 1.2 percent THC, this allows one to be more functional during the day, without causing psychoactive side effects.

What are Side Effects of Marijuana for Back Pain

While medical marijuana is very effective at treating back pain, there is the potential of experiencing side effects. They are usually mild and go away once your treatment wears off. In any event, it’s good to know what they are, so you can sit down with your doctor to discuss them. There are certain side effects each patient should know about the use of marijuana for back pain, or any other pain. The side effects are usually mild and can go way as a treatment wears off. Patient should discuss the side effects with their doctor. Some of the common side effects are as follows:

  • Redness of Eyes: Commonly patients will experience redness of eyes. This is not harmful and can be treated by using eye drops such as Visine.

  • Short-term memory loss: This is a temporary side effect and does go away as the treatment wears off. Some patients may be more susceptible to it than the others.

  • Heightened sensory perception: This side effect can impact a patient’s site, hearing, sense of taste and smell.

  • Fatigue: This side effect is common with high THC strains. One can balance it with the use of low THC strains.

Why do I get lower back pain with PMS?

There could be multiple reasons for back pain, around the time of your period:

1. Not drinking enough water – this can affect the whole body system, and is especially important around your period.

2. Circulatory problems can cause aches and pains – key symptoms are cold hands and feet.

3. Posture could be a factor – we tend to hold ourselves differently around our period – slouching etc.

4. Old injuries can flare up around the time of the month, as water retention can cause added inflammation.

What is Spinal Cord Stimulation?

Spinal Cord Stimulation

Spinal cord stimulation patients use an implanted device to send electrical signals to the spinal cord in order to provide pain relief. The stimulator is activated by the patient using a remote control that triggers the implanted device to send electrical signals to the spine. The internal stimulator consists of electrodes placed near the spinal cord and a small battery pack that is often placed in the abdomen or the buttock. 

This treatment method is often used when nonsurgical treatment options have proven ineffective at reducing pain.  

Treatable Conditions

Spinal cord stimulation is used to treat several conditions that lead to chronic pain, including post-surgical pain, inflammation, peripheral vascular disease, neuropathy, post-amputation pain, and other types of pain causing conditions. When other surgical options to treat back pain are not successful, back pain can be treated by spinal cord stimulation. Arachnoiditis, pain caused by inflammation of the membrane that covers the brain and spinal cord can also be treated using this procedure. Likewise, patients suffering from certain types of abdominal pain such as visceral and perineal pain may also benefit from spinal cord stimulation. 

During the Procedure

Implantation of the device usually is performed in two phases, the first of which is a trail period. During the trial period a temporary device is implanted using a type of x-ray technology, known as fluoroscopy, as a guide to assist in the proper placement of the electrodes into the spine. During the trail phase the battery pack remains on the outside of the body and is usually worn on a belt around the waist. Then, pain levels are tracked for a period of time after implantation. If the patients’ pain is significantly reduced by the device, a permanent option may be considered. However, if a satisfactory level of relief is not reached with the temporary device, it can be removed without injury to the spinal cord and nerves.

For those who move on to the second phase, which involves implanting a permanent device, another surgery is required but this is usually performed as an outpatient surgery. During the procedure the previous electrodes are replaced and secured more permanently in the affected area to prevent shifting. The battery pack is also implanted beneath the skin at this time. All together the procedure takes a couple hours, during which the patient may remain awake to help the surgeon to ensure proper placement of the electrodes into the spine to provide the most relief.

Expected Outcome

Usually patients are released the day of the procedure with certain restrictions. Patients may be asked not to perform certain movements that are likely to pull at the incision sites, such as stretching and twisting, for a period of time following the procedure.  Most patients return to work, with their surgeon’s approval, within a couple of weeks following the procedure.

Side Effects and Complication

 As with any surgery, some complications are possible these include bleeding and infection at the site of the incision. Another possible complication includes, instances where the electrodes shift from the intended location, reducing the level of pain relief. In these instances, additional surgery may be required to return the electrodes to their original location. If the stimulator breaks, due to a fall a new device may need to be re-implanted. In some instances, the dura mater that surrounds the spinal cord may be punctured by a needle or electrode during the surgery resulting in leaking spinal fluid. Consequently, severe headaches may occur. Also, trauma to the spinal cord that may result in paralysis may occur during surgery; although, this complication is rare. 

Driving and operating heavy machinery are not recommended when using a spinal cord stimulator. The device should be switched off before performing these activities.





How Yoga Helps Reduce Back Pain

Physical Benefits of Yoga Exercises

Strengthening from holding yoga positions. Yoga helps increase strength in very specific muscles and muscle groups. Holding positions in yoga is not intended to be uncomfortable. However, it does require concentration and specific use of muscles throughout the body. Muscle strength improves by remaining in these yoga positions and incorporating various movements.

Many of the postures in yoga gently strengthen the muscles in the back, as well as the abdominal muscles. Back and abdominal muscles are essential components of the muscular network of the spine, helping the body maintain proper upright posture and movement. When these muscles are well conditioned, back pain can be greatly reduced or avoided.

Stretching and relaxation from yoga. Yoga incorporates stretching and relaxation, which reduces tension in stress-carrying muscles. Yoga requires that the individual hold gentle poses anywhere from 10 to 60 seconds. Within the pose, certain muscles flex, while others stretch, promoting relaxation and flexibility in muscles and joints.

For people with lower back pain, stretching is very important. For example, stretching the hamstring muscles (in the back of the thigh) helps expand the motion in the pelvis, decreasing stress across the lower back. In addition, stretching with yoga increases blood flow, allowing nutrients to flow in, toxins to flow out, and overall nourishment of the muscles and soft tissues in the lower back.

Breathing is considered very important during the yoga poses. While holding a position, the tendency is to hold the breath as well. Instead, the intention is to have a deep, free, and rhythmic breath through the nose on both the inhale and the exhale. The quality of the breath in many ways determines the quality of the yoga practice. This will emphasize a relaxed body and encourage strong circulation.

Posture, balance, and body alignment through yoga. The yoga poses are meant to train the body to be healthy and supple. Consistent practice and application will result in improved posture, and an increased sense of balance, with head, shoulders and pelvis in proper alignment. Additionally, unlike many other forms of exercise, yoga helps stretch and strengthens both sides of the body equally.

Awareness of the body through yoga increases with practice. In theory, specific positioning and repositioning not only limbers the body, but also trains people to understand the limitations of their body. An increased awareness acts as a preventative measure, in that the individual will know what types of motions should and should not be avoided.

Mental Benefits of Yoga Exercises

Engaging in Hatha yoga affords the practitioner with a mental state of mind that is ready for meditation, which in turn reduces stress and enhances mood. These mental benefits play an important role in the overall healing benefits of yoga.

There are several theories as to why a mental state of mind may affect those suffering from back pain.

  • Many believe that suffering from back pain increases because of perception. Negative psychological and emotional factors may not necessarily change the physiology of the back, but may tend to magnify a problem that already exists. Thus, reducing the perception of the pain (such as through meditation) can reduce the overall feeling of back pain.
  • Others take the role of mental factors one step further. They believe that psychological and emotional factors are the primary influence in the sensation of pain and can physically alter the body. For various reasons, high stress and negative emotions may actually cause back pain. This will in turn create negative psychological and emotional feelings, perpetuating the cycle.

In theory, yoga helps people concentrate their energy on breathing and maintaining posture. The methodical breathing increases oxygen flow to the brain and sets a rhythm within the body and mind. This action coupled with the poses and sometimes meditation is said to dissipate stress and anxiety, therefore, relieving back pain caused by psychological and emotional factors.

How does CBD help fight low back pain?