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Epidural Steroid Injection

Procedure Benefits:

  • 50% of patients receive some pain relief
  • Improve a patient’s mental health and quality of life
  • Minimize the need for painkiller use
  • Potentially delay or avoid surgery
  • Performed in office
  • Patient goes home within 30 minutes
  • More rapid improvement in pain relief than other nonsurgical alternatives

Overview

epidural

What is an epidural steroid injection?

An epidural steroid injection is an outpatient procedure for treating neck, back, or extremity pain. For this procedure, a corticosteroid (anti-inflammatory medicine) is injected into the epidural space of the spinal column to reduce inflammation. A local anesthetic (numbing medicine) may also be injected. Depending on where you are experiencing pain, this injection will take place in one or more of the four regions of the spinal column: Cervical, Thoracic, Lumber, Sacral.

See Also: Learn more about the anatomy of the spinal column

There are two techniques a physician may use for this procedure, interlaminar and transformainal, depending on the approach the physician uses.

About the Procedure

A local anesthetic will be used to numb your skin. The doctor will then insert a thin needle directly into the epidural space. Fluoroscopy, a type of x-ray, will be used to ensure the safe and proper position of the needle. A dye may also be injected to make sure the needle is at the correct spot.

Once the doctor is sure the needle is correctly placed, the medicine will be injected.

After the Procedure

You will be monitored for up to 30 minutes after the injection. When you are ready to leave, the staff will give you discharge instructions. You will also be given a pain diary. It is important to fill this out because it helps your doctor know how the injection is working.

It may help to move in ways that hurt before the injection, to see if the pain is still there, but do not overdo it. Take it easy for the rest of the day. You may feel immediate pain relief and numbness in your back and leg for a period of time after the injection. This may indicate the medication has reached the right spot.

Your pain may return after this short pain-free period, or may even be a little worse for a day or two. It may be caused by needle irritation or by the corticosteroid itself. Corticosteroids usually take two or three days to start working, but can take as long as a week. You can usually return to work the day after the injection, but always check with your doctor.

As with any procedure, there are potential risks. Although discography is designed to minimize these risks as much as possible, there is a chance that complications could occur. Be sure to discuss the possible risks with your doctor. Also, please note that not all patients are candidates for discography. For more information on specific risks, please speak with your physician.

Glossary

Interlaminar– This is when the needle is placed from the back of the spine. It is most common approach for this procedure.

Transformainal– This is when it is done from the side where the nerve exits the spine. This technique puts the medication near the source of inflammation.


Frequently Asked Questions


How long can I expect pain relief?
The extent and duration of pain relief may depend on the amount of disc, dural or nerve root inflammation. Other coexisting factors may be responsible for your pain. Sometimes an injection brings several weeks to months of pain relief, and then further treatment is needed. Other times, a single injection brings long-term pain relief.
If your pain is cause by injury to more than one area, only some of your symptoms may be helped by a single injection.
How long does it take?
Epidural steroid injections are performed on an outpatient basis. The procedure typically requires 20 to 30 minutes, including preparation time.
How often should this procedure be done?
Up to three injections may be given within a six-month time frame. Usually, the injections are performed two to three weeks apart. A set of three injections is the norm; however, you may gain considerable relief after the first or second injection. In that instance, further injections may not be necessary.
What are the alternatives?
Conservative treatment (e.g. physical therapy, exercise regimens and nonsteroidal anti-inflammatory medications) is often used first. Surgery is a possible alternative, however, these procedures may be an adequate treatment, providing temporary relief. These procedures can help determine if surgery would be of benefit by more precisely localizing the source of your symptoms.