What is the epidural space?
The membrane that is outside of the spinal cord and nerve roots in your spine is called the dura membrane. The space surrounding the dura is the epidural space. Nerves travel through the epidural space to your neck, back, legs and arms. Inflammation in these regions can cause irritation from a damaged disc or from contact in some way with the bony structure of the spine.
What is an epidural steroid injection and why is it helpful?
An epidural injection places anti-inflammatory medicine into the epidural space to decrease inflammation of the nerve roots, hopefully reducing your pain. The epidural injection may help the injury to heal by reducing inflammation. It may provide permanent relief or provide a period of pain relief from a few days too several months while the injury or cause of your pain is healing.
What will happen to me during the procedure?
An IV will be started so that sedation can be given. You will be positioned in such a way that your doctor can best visualize the area to be injected. The skin on your back or neck will be scrubbed using sterile scrub (soap). Next, the physician will numb a small area of skin where the epidural needle will be placed. This medicine can sting for several seconds. After the numbing medicine is effective, your doctor will direct a small epidural needle using x-ray guidance into the epidural space. A small amount of contrast (dye) is then injected to insure proper needle position in the epidural space. Then, a mixture of numbing medicine (anesthetic) and anti-inflammatory (cortisone/steroid) will be injected.
What will happen after the procedure?
You will go back to the recovery area where you will be monitored for 30-60 minutes. You may experience some numbness and / or weakness into your legs or arms for a few hours. The steroids may reduce your pain as early as 3-5 days after the procedure and may continue to improve your pain for up to fourteen days. You should have a follow up visit 2 weeks after the procedure to determine if further treatment is needed. These injections are often performed in a series of three (3) to provide the best possible results.
General Pre/Post Procedure Instructions
You should not eat or drink anything after 12 o’clock the night before the procedure. If you are a diabetic, do not take your insulin or oral medication the morning of the procedure because you have had nothing to eat. If you are taking routine heart or blood pressure medicine, you should take it with a sip of water the morning of the procedure. You should not take medications that may give pain relief or lessen your usual pain. These medicines can be restarted after the procedure if they are needed. If you are on Coumadin, Heparin, Plavix, or other blood thinners (including aspirin and all medications that contain aspirin), you must notify the office well in advance so the timing of these medications can be coordinated with your primary physician.
You will be at the hospital / surgery center for a few hours for your procedure. A driver must accompany you and be responsible for driving you home. No driving is allowed the day of the procedure. You may return to your normal activities the day after the procedure, including returning to work.
If you are unable to keep this appointment, please give notice as soon as possible and at least 24 hours in advance. Thank you.