Lumbar spinal injections can help reduce back and leg pain and are a highly requested treatment at our offices.
But there are also plenty of misconceptions about them.
Can epidurals be a first-line treatment for low back pain? How well can they help us determine a source of pain? Can injections heal discs?
We brought on Dr. Joseph Zuhosky, who recently joined our team at Carolina Neurosurgery & Spine Associates, to get answers to these questions and more. Along the way, we hope to alleviate some myths and points of confusion about spinal injections.
Joe gives us his recommendations for when – and how – to treat pain with epidurals, explaining how they can not only help treat pain, but also help narrow down a pain’s source and identify further treatment.
“​​I think there definitely is a role for epidural steroid injections in identifying pain generators. And if it doesn't give our patient long-term, effective relief that they can live with, it helps our surgical partners to determine that it is, indeed, a level that we can reliably operate on.”
Toward the end of this episode, we also hear more about Joe’s personal experiences with disc herniations and how he’s been able to recommend exercises based on his own experience with the workout group he co-founded.
 
? Featured Expert ?Name: Joseph P. Zuhosky, MD
What he does: Before joining us recently as a physician at Carolina Neurosurgery & Spine Associates, Dr. Zuhosky went to medical school at The Ohio State University. He did his residency at the Rehabilitation Institute of Chicago at Northwestern University McGaw Medical Center and completed a fellowship, training in sports and spine rehab, at the Illinois SPINE & Sportscare Centers, Ltd. in Bloomingdale, Illinois.
Company: https://www.cnsa.com/ (Carolina Neurosurgery & Spine Associates)
Words of wisdom: “I don't think we should take all the credit for healing the disc … it's a thought of managing it going forward because even when the pain isn't there, you still have a weak area of your body that you're going to have to compensate for going forward.”
Connect: https://www.cnsa.com/providers/joseph-p-zuhosky-md (Website)
 
⚓ Anchor Points ⚓Top takeaways from this Back Talk Doc episode
★    Injections are more than just a band-aid. Some patients worry that getting a spinal injection will only be a temporary fix for their pain. But it actually does a lot more than that, as long as the injections are used appropriately. While pain relief may only be temporary, an injection can tell us more about where the pain comes from and gives us clues on further ways to treat the patient.
★    A ‘series of three’ injections can limit treatment options. The ‘series of three’ injections myth stems from https://www.ccjm.org/content/27/4/191 (a research study on sciatica) originally published in 1960, but further research found this treatment is only effective two times out of three. Since doctors can only give a limited number of injections within a period of time, this method can also rule out other treatment options that offer quicker relief.
★ An epidural is only one part of treatment. While a shot can relieve pain, it can’t actually heal a damaged disc. Instead, the epidural steroid reduces the swelling and inflammation that causes pain, getting the patient through the acute stage while Mother Nature does the rest of the work.
 
⚕️ Episode Insights ⚕️[00:00] Check out our sponsor: https://qxmd.com/ (QxMD) builds mobile solutions that drive evidence-based medicine and clinical practice.
[01:59] Meet Dr. Joe: https://www.cnsa.com/providers/joseph-p-zuhosky-md (Joseph Zuhosky) is the newest member of Carolina Neurosurgery & Spine Associates. Before joining us, he did his residency at the Rehab Institute of Chicago at Northwestern University and a fellowship in sports and spine rehab in Bloomingdale, Illinois.
[04:05] From pediatrics to orthopedics: Dr. Zuhosky...