Epidural Steroid Injection

An epidural steroid procedure injects anti-inflammatory medication into the epidural space of either the cervical, thoracic, lumbar or sacral areas of the spine, close to the inflamed nerve. The spinal cord and the nerve roots are contained within this space and may become inflamed due to irritation from disc herniation or rupture, arthritis or spinal stenosis (narrowing of the spinal canal). Complications are rare, but can include pain, blood pressure changes, dural puncture, headache or nerve injury. Depending on the location of the procedure and your response, you may require a ride home. Many patients experience pain relief for several months and some may even have permanent pain relief.

When you arrive, a nurse will obtain a description of your pain and how you are managing daily activities. Your blood pressure, pulse, temperature and weight will be recorded. Medications, allergies and a brief health history will be reviewed. It is important to let the nurse know if you have allergies to X-ray dye, Betadine or latex, if you are taking blood thinners, such as Coumadin, Plavix, Pradaxa or Lovenox if you have diabetes or if you might be pregnant. .

After discussing treatment with your physician and signing procedural consent, you will go to the X-ray room where you will be helped onto the X-ray table into the best position for visualizing your spine. We will try to make you as comfortable as possible. Your skin will be cleansed with antiseptic and after numbing the skin with local anesthetic, the physician will place a small needle into the epidural space using fluoroscopic guidance. A small amount of contrast dye may be injected to confirm the proper placement of the needle and the steroid will be injected. The entire procedure will take less than a couple of minutes.

The anesthetic can make your arms (cervical) or legs (lumbar) feel weak or numb so plan to stay with us for about 15 to 20 minutes after your procedure. A nurse will be available to answer any questions you might have and to review discharge instructions and follow-up care.

When you go home

  • Activities: Rest and avoid activities that might aggravate your pain. You can usually return to work and exercising on the next day.
  • Pain: Ice on the injection site and taking your regular pain medications will help with any discomfort. Some patients initially experience more pain after the injection when the anesthetic wears off because the steroid can be irritating to the nerves.
  • Follow-up: Make an appointment for follow up or to repeat the injection in two to four weeks.

Many patients will have pain relief after the first or second injection. Some patients will need three injections, don’t be discouraged! Talk with your physician.

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