Epidural Steroid Injection

What is an epidural steroid injection?

An epidural steroid injection is a long lasting steroid into the epidural space in your back. The epidural space is the area surrounding the spinal cord and the nerves coming out of the spinal cord.

What is the purpose of an epidural steroid injection?

The steroid medication injected will help to reduce the inflammation and/or swelling around the nerves in the epidural space. This is turn may reduce your pain, tingling, numbness, and/or any other symptoms that may be causing nerve inflammation, irritation, or swelling.

How does the physician perform an epidural steroid injection?

The physician's assistant will need to position you first. Depending on where the epidural injection is being done (i.e. neck, upper or lower back), you will be either sitting, lying on your side, or lying on your stomach. The skin on your back will be cleansed with an antiseptic solution. The procedure does involve inserting an epidural needle through the skin and deeper tissues. The physician will first numb your skin and deeper tissues with a local anesthetic. You will have a pressure sensation when the physician injects the steroid into the epidural space. After the physician is finished with the injection, the assistant will clean your back and place a dressing on the injection site.

If "fluoroscopy" (x-ray) is going to be used to assist the physician with the placement of the steroid, you will be taken to the Procedure Room. If there is a possibility that you could be pregnant, be sure to inform the staff.

When can I eat and drink?

After the procedure is finished, you will be given something to drink. Crackers are available upon request. After you leave the Pain Medicine Clinic, you may have a meal. You will then want your driver to take you home so you can rest.

Will the epidural steroid injection help me? If so, for how long?

It is difficult to predict if the injection will indeed help you or not. Generally speaking, the patients who have radicular symptoms (i.e. pain down the leg) respond better to the injections. You should start noticing some relief within 3 to 7 days. If you do get relief from the injection, its effect can last for several days to a few months or longer. If you have no relief after 14 days, please call the Pain Medicine Clinic to reevaluate your treatment.
How often can I have epidural steroid injections?

Your physician will request a return appointment, usually within 4 to 6 weeks. If you have had significant relief from the epidural injection, you may not need another injection. If you have had some relief from the epidural injection, your physician may recommend a second and possibly a third epidural injection. However, there is a limit on the number of epidural injections you can receive over a period of time.

What are the risks and side effects?

Generally speaking, this procedure is safe. However, with any procedure there are side effects, risks, and possible complications. The most common side effect is temporary pain. Some others include headaches, infection, bleeding inside the epidural space with nerve damage, and worsening of symptoms. Other risks are related to the side effects of cortisone, which might include weight gain, increase in blood sugars (mainly in people with diabetes), or water retention, all of which are temporary.

Who should not have an epidural steroid injection?

If you are allergic to any medication to be injected, if you are on a blood thinner medication (i.e. Coumadin), or if you have an active infection, you should not have the injection. The physician may postpone the injection if you are currently on aspirin or an anti-inflammatory medication.

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