If you’ve ever been in labor, or know someone who has, you’ve heard of an epidural. The term is an adjective that has also become a noun, describing one of the most common analgesic procedures available in modern medicine.

But epidurals are used widely and effectively outside of the delivery room as well. Decades of practice, refinement of the tools and drugs used in the procedure, and significant amounts of research have shown epidurals to be a safe and effective way of easing severe pain associated with childbirth, chronic back pain, surgery, and more.

Nevertheless, plenty of people are understandably leery of the idea of a needle being jabbed into their spine without fully understanding where exactly that needle goes, or how the drugs administered during the procedure are supposed to work. Here’s the backstory on epidurals.

From Operating Room to Delivery Room

First devised more than a century ago, doctors in France realized that they could temporarily ease pain or numb sensation by injecting a painkilling drug (initially cocaine, and later, other analgesics and anesthetics) into the epidural space of the spine.

This spinal area lies just outside the dura mater, and is a tough membrane that encases the spinal cord and the system that allows cerebrospinal fluid to circulate.

The procedure was initially viewed as a method to help numb a patient for surgery, after an injury (as in the case of soldiers wounded in battle), or to ease chronic pain conditions, such as sciatica. Epidurals to ease labor weren’t really used in the delivery room until the 1940s; during the next couple of decades, the procedure gradually began to supplant other methods used to ease birthing pains.

The Epidural Procedure Today

Over time, doctors and anesthesiologists refined epidural procedures to include the use of catheters for more controlled delivery of pain-relieving drugs. Pain experts also developed procedures to mitigate chronic spinal or neck pain by administering steroids (rather than a narcotic) to ease inflammation.

In fact, epidural injections for such conditions are far more common — some 9 million are performed per year — than epidurals used during childbirth.

That said, epidurals today are the gold standard for pain management in the delivery room — in the U.S. alone, as many as 75 percent of women in labor opt for the procedure, which is considered safer for expectant moms and their babies than oral or IV painkillers.

Read More: Scientists Debate Why Childbirth is So Brutal

Epidural Risks and Research 

Unfortunately, myths and out-of-date information continue to inspire fear and dread of the procedure. It’s been suggested that epidurals can cause permanent back pain or spinal cord damage. But such risks are negligible when the procedure is performed properly under the care of a qualified professional (typically an anesthesiologist, but orthopedic surgeons, neurologists, radiologists, and other specialists may perform epidurals as well).

While there may be temporary discomfort at the injection site, this goes away quickly. Moreover, epidural needles do not penetrate the dura mater and so do not come in contact with the spinal cord.

Another persistent concern is that epidurals may extend labor, since mothers who receive the treatment may lose lower-body sensation and may not be able to push as strongly as they might without the epidural. The concern here, of course, is that extended labor might necessitate more aggressive delivery methods, including the use of forceps, a vacuum, or even increase need for Caesarian section.

There may have been some truth to these concerns, but in the early decades of the epidural’s use during labor, the refinement of the drugs used during the procedure and the greater ability to control the level of drugs being administered (via catheter) have greatly minimized this risk.

Today, the odds of any serious complications from receiving an epidural are less than 1 percent, to both the mother and the baby.

Managing Pain

Of course, epidurals for any kind of pain relief are still very much an individual choice, and people with some medical conditions — bleeding disorders, or a history of certain spinal conditions or injuries, for example — may not be good candidates to receive an epidural.

Either way, today’s pain-management experts are well-trained and prepared to discuss alternatives. But if you’re concerned about excessive labor pain, or are in agony from a chronic, otherwise intractable pain issue, talk to your doctor about the benefits of an epidural procedure. It just might be worth a shot.

This article is not offering medical advice and should be used for informational purposes only.

Read More: Chronic Pain Makes You Think Differently

Article Sources

Our writers at Discovermagazine.com use peer-reviewed studies and high-quality sources for our articles, and our editors review for scientific accuracy and editorial standards. Review the sources used below for this article:

Before he became editor of Discover in 2012, Steve spent more than 20 years as a writer and editor, specializing in health and medicine. He began his career at a scientific, technical and medical publisher, then moved to consumer-oriented publications, where his work has appeared in Men’s Health, Men’s Journal, Prevention, Outside and dozens of other magazines and web sites.