W hat is an Epidural Steroid Injection?

The Epidural steroid injection is a procedure where local anesthetic and Cortisone is administered into the epidural space, or near the nerve root in the area of the spinal cord. This is usually 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 Pain Management Consultants, the physician examining you in consultation with your referring physician will decide whether you are a candidate for epidural steroid injection.

Usual conditions for which epidural steroid injections are done:

•  Herniated or bulging disc.
•  Sciatica
•  Degenerative disc disease
•  Arthritis of the spine.

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 fifteen to thirty minutes.

Where is the procedure performed?

The procedure is usually done at our outpatient surgery center where fluoroscopy or x-ray facilities are available.

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 or Novocaine, is injected into the skin and tissues below prior to the placement of the epidural needle. The epidural needle is advanced under fluoroscopic guidance into the epidural space. Once the needle is in the epidural space it 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 Cortisone. In certain situations we may not use x-ray.

I am afraid of needles. Will I have a lot of pain?

Your physician will do everything possible to do the procedure with minimal 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 very comfortable and at peace during the procedure. On occasion we will need to interact with you.

What should I expect after the procedure?

Immediately after the procedure you may have relief of your 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. On the second and third day, your pain may even get worse. Starting on the fifth day, you may see gradual improvement in your symptoms.

What should I do after the procedure?

You should make arrangements for someone to drive you home. You should take it easy for that day and rest. 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 Advanced Pain Consultants, 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, still you can 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.

What should I do if I develop a headache?

Please inform your physician. He will discuss with you, in detail, about the treatment plan including the occasional use of blood patch to treat the post-epidural headache.

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 Pain Management physician, along with your referring physician.

How should I prepare for the procedure?

You should not eat or drink anything six (6) hours before the procedure. You should stop taking any blood thinners like aspirin, at least five days before the procedure. You can take all of your other medications with a sip of water.

DIABETES:If you are a diabetic, please discuss with your physician, regarding your medications.