These kinds of injections are used to treat nerve inflammation, which can cause neck, shoulder, arm, back or leg pain.
The membrane that covers the spine is called the dura. The space that surrounds it is called the epidural space. When the nerves that travel along the dural membrane become inflamed, it can be quite painful. Inflammation can occur when the discs that normally cushion the spine are damaged or rub up against the bony structure of the spine.
An epidural steroid injection involves an injection of steroidal medication to the epidural space to reduce the swelling of the nerve roots. Usually a total of (3) epidural injections are given about 1-2 weeks apart. Although the epidural injection may not provide permanent pain relief, it may bring relief for several weeks or months while the injury/cause of pain is healing.
Information for Patients
Along with steroidal medications such as Depomedrol or Kenalog, numbing medications similar to ones used in dentists' offices are injected into the epidural space during this procedure. These injections usually take anywhere from a half an hour to an hour to complete.
If your procedure is scheduled in the morning, please don't drink any liquids or eat any solid foods after midnight. If your injection is scheduled in the afternoon, you may have water or apple juice on the morning of the procedure, up to two hours before the injections.
If you are taking any blood thinners such as Coumadin and Plavix, you must stop taking them a week before your injection. Let your primary care doctor and Pain Management Center physician know before you stop taking your blood thinners.
Before the procedure, you will have an intravenous (IV) catheter placed in your arm or hand. This IV will provide you with fluid and medication that may make you feel a little drowsy. You will then be placed on your stomach and your back will be numbed with a local anesthetic before your doctor inserts a small needle. Once the needle is in place, a numbing medication such as Bupivicaine will be injected into the epidural space, along with the steroid medicine.
When the procedure is over, the numbing medicine may make your arms feel temporarily weak. Therefore, you should limit your activity on the day of your procedure. You will need to stay at the Pain Management Center an additional half an hour to fully recover. Someone should accompany you home after the injection because you will not be able to drive. You can usually resume normal activity the day after your procedure.
Once the numbing medication wears off, your pain will likely return. The steroid medication may provide longer lasting pain relief, but probably won't begin working for 24 to 48 hours after the injection. We usually give three steroidal injections, one to two weeks apart. We hope that the injections relieve your pain, but there are no guarantees that they will.
You may experience bruising or tenderness at the injection site(s) and your pain may get worse a day or two after the block. Please call our office (410-328-5063) if you develop a fever greater than 100.5 degrees, experience any unusual pain symptoms such as a headache that won't go away or if the weakness in your arms persist. Even if you don't have any unusual symptoms, we'd like to hear from you the day after your procedure to see how much pain relief you get from the injection and how long the pain relief lasts.