What is an Epidural Steroid Injection?
The Epidural Steroid Injection is a procedure where numbing medicine (anesthetic) and anti-inflammatory medicine (steroid) is injected into the epidural space to threat pain caused by irritation of the spinal nerves. A protective covering called dural sac surrounds the spinal cord. This sac contains spinal fluid that bathes and nourishes the spinal cord. The space between the outer surface of the dural sac and the bones of the spinal column is the epidural space. Nerves that go from the spinal cord, through the spinal column and to the body pass through the epidural space. Depending on the location of your pain, the epidural steroid injection can be given in the neck (cervical), middle back (thoracic) or lower back (lumbar).
Epidural Steroid Injection Procedure Overview
The Epidural Steroid Injection is an outpatient procedure done in the Operating Room or a Special Procedure Room. For your safety and comfort, the doctor may decide to connect you to a monitoring equipment (EKG monitor, blood pressure cuff, and blood oxygen monitoring device). In addition, the doctor or nurse may start an intravenous line and give some medicine to help you relax. Depending on the area to be injected, you will lie on your stomach or sit in a chair. After your skin is cleansed with an antiseptic solution the doctor will inject some numbing medicine that will produce a burning sensation for a few seconds. After the numbing medicine takes effect, the doctor will insert another needle and with the assistance of a special X-ray machine called a fluoroscope, inject a radiopaque dye (cortisone/steroid). It is possible you will feel pain similar to your normal back pain as the medicine is injected. This is a good sing and means the medicine is going to the right place. The pain usually disappears quickly. After the procedure, we ask that you remain at the Clinic until the doctor feels you are read to leave.
Will you be asleep for the procedure? If is not necessary for you to go to sleep for this procedure; however you will receive enough medication to keep you comfortable.
How long will the procedure take? Normally, an epidural steroid injection takes no more than 10 to 15 minutes.
Before the Procedure
Since you will be receiving medication, it is recommended that you do not eat within eight hours before the procedure. If you are a diabetic, be sure to discuss eating and medication with your doctor. You may need to stop taking certain medications several days before the procedure. Please remind the doctor of all prescription and over-the-counter medications you take, including herbal and vitamin supplements. The doctor will tell you if and when you need to discontinue the medications.
It is very important to tell the doctor if you have asthma, or any allergic reactions (i.e. hives, itchiness, difficulty beatheing) any treatment which required hospitalization to the injected dye for a previous radiology exam (CT San, Angiogram, etc.) or if you have had an allergic reation to shellfish (shrimp, scallops, lobster, crab, etc.) The doctor may prescribe some medications for you to take before having the procedure. Tell the doctor if you develop a cold, fever, or flu symptoms before your scheduled appointment.
After the Procedure
You may experience some weakness and/or numbness in your legs (lumbar injections), arms (cervical injection), or chest wall (thoracic injection) for a few hours after the procedure. If so, do not engage in any activities that require lifting, balance and coordination. Drink plenty of clear liquids after the procedure to help remove any dye from the kidney. Do not drive for the remainder of the day. Please have an adult drive you home or accompany you in a taxi or other public transportation. Depending on how you feel, you may resume normal activities and return to work the following day. If the doctor prescribes physical therapy, it is very important that you continue with the physical therapy program. Although you may feel much better immediately after the injection (due to the numbing medicine), there is a possibility your pain may return within a few hours. It sometimes takes a few days for the steroid medication to start working.
The risks, although infrequent include:
- Allergic reaction to the medication
- Never Damage.
- Bruising at the injection site
- Infection at the injection site
- Puncture of the dura resulting in a headache
If you experience severe back pain, new numbness, weakness of your legs, a headache that will not go away or sign of infection in the area of injection, you should call the doctor immediately.