What is an epidural steroid injection?
An epidural injection is an injection of steroid into the epidural space located in the spine between the bones of the spine and the spinal cord. The steroid reduces the inflammation of the nerve roots as they exit the spine, which can help alleviate pain in the neck, pack, and/or limbs.
How is the injection performed?
The patient lies on his/her stomach and the skin on the back or neck is cleansed with an antiseptic solution. An injection of anesthetic medication to numb the injection site. Then, an X-ray machine helps guide the needle into the epidural space. Once the epidural space is entered, X-ray contract is injected to ensure correct positioning of the needle, then medication consisting of a numbing medicine and a steroid will be injected. The procedure takes approximately 15 minutes.
Will the injection hurt?
There is some discomfort with needle insertion which we minimize by numbing the skin over the joint with a local anesthetic. You may elect to have a small amount of sedating medication to help with discomfort and to help you relax. If you elect to receive sedation, you may not ear or drink after midnight the night before the procedure, and you must bring someone with you to stay with you during the procedure and drive you home.
How long does the effect last?
The effect might last a few hours to a few weeks or much longer. Pain relief in the first couple of hours after the injection is the most important as this tells us our diagnosis is likely correct. If the symptoms do return, we will discuss options available for continued pain relief, which may include repeating the injection for additive benefit.
What is the next step after the injection?
You will be given a pain log to complete after the procedure. This will help us to measure your response to the injection and determine the next most appropriate plan of care.
What are the risks and side effects?
Serious side effects and complications are rare. The most common problem after the injection is having pain near the site of the injection for a few days. The other complications are infection, bleeding and nerve injury. These complications are minimized by stopping the blood thinners, using sterile technique, and fluoroscopy for X-ray needle.