- What is an epidural steroid injection?
An epidural steroid injection is the injection of steroid medication into the epidural space.
- What is the epidural space?
The epidural space is the area around the spinal cord. The spinal cord is protected by three layers or coverings. The outermost layer is called the dura mater. The epidural space is the area between this outer layer (dura mater) and the vertebral canal.
- Who can benefit from epidural steroid injections?
Epidural steroid injections are an effective treatment for patients with:
- Back or neck pain that radiates or spreads down the legs or arms.
- Herniated or bulging disc.
- Post laminectomy syndrome.
- Nerve root compression from spinal stenosis.
- How do epidural steroid injections help?
Steroids are medications that help decrease inflammation. When the inflammation in the involved area is decreased, swelling and pain are also decreased in the area. (The steroids used in epidural steroid injections are not the same type of steroid used by some athletes to boost their performance.) By injecting steroids in the affected area rather than giving them by mouth, a smaller dose can be used to produce favorable results.
- How soon will the treatment help?
The onset of relief is usually within 48-72 hours however, it may take as long as a week for the medication to provide you with relief. During the first 24-48 hours after the injection, you may notice a slight increase in pain or you may notice different patterns of pain. This is due to the slight bruising that may occur from the needle, or from the pressure caused by the volume of medication that has been injected. This discomfort will subside as the medication is absorbed.
- How often can these injections be repeated?
Epidural steroid injections may be repeated as frequently as two weeks. You may have a total of three epidural steroid injections in six months or a total of four epidural steroid injections each year.
- What are the benefits of epidural steroid injections?
- Decrease in pain
- Return of movement and mobility
- Possible avoidance of surgery
- May be used in combination with physical therapy
- Are there risks or hazards with epidural steroid injections?
As with any procedure, there is the potential for problems. The risks are minimal with epidural steroid injections. Problems that may occur are:
- Temporary numbness of the arms or legs
There may be an increase in your blood sugar or blood pressure. Some people may occasionally experience an increase in appetite, weight gain or fluid retention. These side effects however, are not common.
- Are epidural steroid injections painful?
A local anesthetic (numbing medicine) is injected into the skin before the procedure to minimize discomfort and for many people this is the most uncomfortable part of the procedure. Some people state that they have a sensation of pressure but feel no pain during the injection. This discomfort is minimal for the majority of people.
- How are epidural steroid injections performed?
The epidural steroid injection is performed in the “Fluoro Room.” You will be positioned on the X-ray table in a face down position. An R.N. will stay with you during the procedure. After cleaning and numbing the skin, the physician will use X-ray guidance to place the needle in the epidural space.
A C-arm (a type of X-ray machine) is used during the procedure. This enables the physician to place the needle more precisely or accurately into the epidural space. The use of X-ray during procedures ensures a more precise injection as well as providing an extra measure of safety to the patient.
After the physician has completed the injection, the R.N. will clean the area and place a dressing over the injection site. Your blood pressure will be checked and you will be given instructions on how to care for yourself.
- How should I care for myself after the injection?
You should take it easy on the day of the injection. Bedrest is not needed. Do not vacuum, perform yard work or engage in strenuous activities. Normally you may resume your normal activities the following day. Remember however, that you most likely will not experience pain relief for 2-7 days.
If the injection site is uncomfortable, you may apply ice to the injection site during the first 24 hours after the injection. After 24 hours, you may apply ice or heat if you wish. Whatever you choose to use, apply only 20 minutes at a time (20 minutes on/20 minutes off). Continuous use of ice or heat may damage your skin.
You may continue your pain medications as needed.
You should take your other medications as prescribed and continue your normal diet.
Please notify the physician if you experience:
- A headache not relieved by your usual headache medications
- Bleeding from the injection site
- Dizziness or weakness
- Signs of infection at the injection site