What are Epidural Steroid Injections?
An epidural steroid injection is an injection of local anesthetic (numbing medicine) and steroid medication into the epidural space.
How Epidural Steroid Injections work?
The epidural space is located outside the membrane covering the spinal cord and nerve roots. Nerves travel through the epidural space to the back and into the legs. Inflammation of these nerve roots may cause pain in these regions due to irritation from a damaged disc or contact with the spine's bony structures.
An epidural steroid injection aims to provide pain relief by reducing the nerve roots' inflammation (swelling) as they exit the spine. This is done by injecting anti-inflammatory medicine into the epidural space. An epidural steroid injection will not correct the pre-existing medical problem (spinal stenosis, herniated or bulging disc, arthritis, etc.), but it may improve pain level. It is not unusual for a patient to require more than one injection to receive long term benefits.
The injections are done in a series of three about 3-4 weeks apart if needed. If the pain significantly improves, no further injection is required unless the pain begins to come back.
Note: The procedure cannot be performed if you have an active infection, flu, cold, fever, very high blood pressure, or if you are on blood thinners. Please make your doctor aware of any of these conditions. This is for your safety!
How Epidural Steroid Injections help you?
Many spinal conditions, including a lumbar herniated disc, can cause inflammation or pressure on the nerve roots leading out of the spine, resulting in pain, tingling, or numbness along those nerves. A lumbar epidural steroid injection may be used to reduce the inflammation around the spinal nerves.
How do I prepare for my procedure?
No solid food or fluids after midnight prior to the procedure unless directed otherwise. You may take your medications with a small amount of water. People with diabetes should not take their medication until after the procedure is complete. Please check your blood sugar at home. If you are taking any blood thinners such as Coumadin, Warfarin, Plavix, or others, these medications must be discontinued well before the procedure. Please make your Pain Management doctor aware that you are taking a blood thinner, and contact your primary care physician or prescribing physician before stopping this medication.
What happens during the actual procedure?
After the doctor examines you and goes over the risks and benefits, he or she will ask you to sign a consent form. You will then be assisted to the table and made as comfortable as possible lying on your stomach.
What can I expect during Epidural Steroid Injection treatment?
During the procedure, the patient lies down with a cushion underneath their stomach to increase flexion in the lumbar spine, giving more room for the needle to pass through. First, a local anesthetic is used to numb the skin above the injection site. The needle is guided into the epidural space. Contrast dye is injected to confirm the proper placement of the needle in the epidural space. The injection itself may include a local anesthetic and/or saline along with the steroid medication to give immediate pain relief and flush the area of inflammatory agents.
The mixture is injected, and the steroid acts to reduce the inflammation around the spinal nerve roots. The needle is removed, and a small bandage is placed on the injection site. The patient is monitored for a short time before being discharged home.
After the injection, your skin will be washed and a band aid will be applied. Your blood pressure will be monitored in the recovery area for an appropriate time (usually 20-40 minutes), and you may be offered juice/soda and graham crackers. You will be given written and oral discharge instructions. You may go home with your driver after your doctor authorizes discharge.
How will I feel after the injection?
You may experience temporary relief after this procedure that may last several hours. Once the numbing medication wears off, your pain may return.
The steroid medication usually takes two or three days to begin affecting most people; therefore, it may be awhile before you feel a change in your pain. In rare cases, your pain may increase for a few days before improving. Some local tenderness may also be experienced for a couple of days after the injection. Using an ice pack three or four times a day will help alleviate this. You may take your usual pain medications after the injection. People with diabetes may see a short-term elevation of blood sugars from the steroid medication.
You can call Manhattan Wellness Group and make an appointment for a consultation!