Effect of epidural infiltration
Note: This section is for very interested readers The effect of epidural infiltration is based on the injected drugs. Mostly cortisone and a local anesthetic are injected. The cortisone has an anti-inflammatory effect at the site of the injection.
It is a substance that occurs naturally in the body and is produced in the adrenal cortex. Besides regulating metabolic pathways in the body, cortisone has a regulatory function in the immune system. This is relevant for the use of cortisone in epidural infiltration.
It has an anti-inflammatory effect through the inhibition of NFKB. Cortisone is a transcription factor (a protein that controls the reading of DNA and thus the production of proteins) that regulates the synthesis of pro-inflammatory mediators (pro-inflammatory signaling substances), such as prostaglandins. The reduced amount of pro-inflammatory substances reduces the inflammation and thus also the swelling at the problem area of the spine.
Since the swelling no longer constricts the nerve fibers, the pain should ease. The local anesthetic prevents the pain from being transmitted to the site. Local anesthetics used for epidural infiltration are sodium channel blockers.
They work by interrupting the electrical potentials through the nerve via the information transmitted through the nerve or by preventing the formation of electrical stimuli. The exact mode of operation is that the local anesthetics block sodium channels at the nerve fibers – the lack of sodium infiltration does not lead to depolarization of the nerve fiber (becoming positive) and thus to the formation of a potential difference along the nerve fiber. Thus, no more pain signals are transmitted from the previously painful area to the brain.
However, this condition is not permanent. Furthermore, the lack of pain transmission does not stimulate the release of further inflammatory cells to release pro-inflammatory substances, so that this also causes a reduction of the inflammation and thus a further reduction of pain.
