Pain treatments: Interventions... Epidural space injections deliver a local anaesthetic and steroid solution to the virtual space surrounding the spinal cord to produce a widespread effect in the spinal nerves. A variable number of nerves are ‘blocked’ producing both a loss of sensation, and a reduction of muscular activity. There is good evidence for the benefit of the injection which may act by diluting the inflammatory chemicals released from a disc prolapse and which produces inflammation and therefore pain in the local nerves known as ‘radiculitis’.  Epidural injection may be performed at any level in the spine and the space may be entered either from the midline of the back, the caudal hiatus close to the coccyx or tailbone, or through the foramen through which the nerve emerges (transforaminal) Intra dural therapy delivers medications directly to the spinal cord by injection into the fluid within its sheath the dura. It is sometimes necessary to use implantable pumps to deliver effective doses of medication continuously to reduce pain, spasm or to reduce inflammation directly. Such invasive techniques are used in conditions which have failed to respond to more conventional and safer therapies and require close monitoring to prevent complications.  
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