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Epidural Steroid Injection
The epidural steroid injection is a procedure where a local anesthetic and steroid solution are administered into the epidural space or near the nerve as it exits the spinal canal. This is done under fluoroscopy (watching under live x-ray) to deliver the drug to the precise location.
Am I a candidate for an epidural steroid injection?
At Midwest Pain Treatment Center , the physician examining you in consultation with your referring doctor, will decide whether you are a candidate for epidural steroid injection. Usual conditions for which epidural steroid injections are done would be herniated or bulging disc, sciatica, degenerative disc disease, and arthritis of the spine. This is not a complete list of the conditions for which epidural steroid injections are done. Please discuss with your physician for more details.
What are the benefits of an epidural steroid injection?
Epidural steroid injections can reduce inflammation of the nerves and provide pain relief.
How long does the procedure take?
The procedure takes approximately 15 minutes.
Where is the procedure performed?
It is done as an outpatient at our surgical suite under fluoroscopy.
How is the procedure performed?
An IV is started and you will receive sedation through the IV to make you comfortable. A local anesthetic, such as Xylocaine, is injected into the skin and tissues below prior to the placement of the epidural needle. The epidural needle is advanced under flouoroscopic guidance into the epidural space. Proper position of the needle is confirmed by injecting a special dye. We will not use dye if the patient is allergic to the dye. After confirming the needle location, we will inject the local anesthetic and steroid solution.
I am afraid of needles. Will I have a lot of pain?
Your physician at Midwest Pain Treatment Center will do everything possible to do the procedure with minimal, if any, pain. As explained above, you will be given sedation intravenously and numbing medication (local anesthetic) at the site of the needle placement.
Can I be sedated for the procedure?
Yes. You will be awake but usually very comfortable during the procedure. On occasion we will need to interact with you. It is likely that you will have no memory of the actual procedure. You are required to have a driver remain in the facility before and during the procedure, then drive you home following the procedure.
What should I expect after the procedure?
Immediately after the procedure, you may have relief of you pain. Sometimes you may feel numbness in the legs or arms, depending upon where the procedure was done. This is from the local anesthetic that was used during the procedure. Four to six hours after the local anesthetic wears off, your pain may come back. Sometimes your pain may even get slightly worse for up to 48 hours. You may not see full improvement in your symptoms until the 4th or 5th day.
What should I do after the procedure?
After the procedure, you will be required to have someone drive you home. The next day you should be able to resume your normal daily activities that you were doing prior to the procedure.
Can I go to work the next day?
If you are working prior to the procedure, you can go back to work the day after the procedure. If you are not working prior to the procedure, because of the pain and other problems, you should discuss this with your physician at Midwest Pain Treatment Center for further instructions.
What are the risks and side effects?
Usually the procedure is safe. However, with any procedure, there are risks, side effects and complications. The risks, side effects, and complications vary depending upon where the epidural was done. Whenever an injection is done through the skin, there is a risk of infection and soreness. To prevent this, we perform the injection under sterile conditions. In spite of this, you can still develop infections and soreness. In addition, one may develop more numbness than expected depending upon the spread of the local anesthetic. One may also develop a headache if there is spinal fluid leakage. Bleeding in the soft tissues or the spinal canal may occur in rare occasions, especially if you are on anticoagulants ("blood thinner") medications or have various rare conditions that affect blood coagulation. Infection or bleeding in the spinal can may lead to neruologic damage. However, all the complications are extremely rare.
Can you tell me more about the"spinal headache"?
This headache usually develops as a result of spinal fluid leakage from the injection. It has different symptoms than other types of headaches, such as migraines. In our experience, the chance of someone developing a headache is less that 1%. The headache may last anywhere from 5-10 days and may even require an additional procedure called a blood patch.
How many epidural steroid injections do I need?
It varies. It depends upon your response to the first injection. Upon re-evaluation, this will be decided by the physician at Midwest Pain Treatment Center , along with your referring physician.
How should I prepare for the procedure?
Unless otherwise instructed, you should not eat or drink anything 8 hours before the procedure. You should stop taking any blood thinners, at least five days before the procedure. You can take all of your other medications except oral diabetic meds with a sip of water the morning of the procedure. Diabetics, please discuss with you physician regarding your other diabetic medications.