What is an epidural steroid injection?
An epidural steroid injection (ESI) is a common treatment for sciatica, herniated discs, and more. ESI delivers a very powerful anti-inflammatory medication into the epidural space in your spine to relieve pain in your arms or legs.
The epidural space is the area outside of the sac of fluid surrounding your spinal cord. This sac of fluid is called the dural sac. The dural sac encloses your spinal cord, nerve roots, and cerebrospinal fluid. An epidural injection if you have a condition causing radiating pain that hasn’t gotten better after nonsurgical treatments like medicines and physical therapy. By reducing inflammation, an ESI can help to reduce your pain.
Epidural injections are often called steroid injections, back pain injections, or spinal injections for back pain. An ESI can be both a treatment and a way to diagnose a specific nerve root problem if there is a question of the cause of pain.
If you are taking aspirin or blood thinning medication, you may need to stop taking it several days before the ESI. Discuss any medications with your doctors, including the one who prescribed them and the doctor who will perform the injection.
What are steroids?
Steroids are a general name for glucocorticoids. The steroid injected is a man-made, synthetic drug that is similar to cortisol, a natural hormone produced in the body. Steroids help to reduce pain and inflammation and are used to treat a variety of inflammatory conditions, including lumbar disc herniation.
What are the risks?
The potential side effects of an ESI include, but are not limited to:
- Spinal headache
- Temporary leg weakness or numbness
What happens on the day of the procedure?
- You will be awake during the Sedation is occasionally used. Discuss this with your physician when scheduling the procedure.
- If you have diabetes, your blood sugar may temporarily You will be advised to monitor your glucose levels more frequently for the next week after the procedure.
- Continue to take all medications, especially blood pressure Please note that your blood sugar and blood pressure will need to be within a safe range on the day of the procedure.
What happens during the procedure?
- You will be lying face down for the duration of the procedure.
- A provider prepares the injection site, cleaning it and numbing the area. You may be given a sedative to help you relax.
- ● A needle or needles are inserted into your back while viewing the injection site on x-rays that show real time images. This allows for precise placement of medication.
- During injection of the medication, you may feel slight pressure at the injection site. This medication eases swelling and inflammation around on the larger nerves around your spine and helps to lessen pain.
- The procedure will take between 10 and 30 minutes.
- You may experience from one to four injections with needles that are guided with the use of x-rays called fluoroscopy.
Does and epidural steroid injection hurt?
The injection site is numbed with an injection to minimize your discomfort. After your treatment, you might feel a bit of discomfort, but that usually goes away after a few hours. You might also notice that your back pain feels a bit worse for aa day or so after treatment. That is because the steroid usually takes 1-3 days to work.
What happens after the procedure?
- Pain relief may begin immediately after the medication has been injected, or you may not receive pain relief for up to 2 days. You may experience a brief recurrence of your former pain until the anti-inflammatory medication takes Apply ice to the injection site to decrease discomfort.
- A bandage may be placed over the injection site.
- You will rest, lying down, in a recovery room for 15 to 30 minutes.
- A medical assistant will check your blood pressure and pulse, and will also discuss your discharge instructions with you.
- A responsible adult must drive you home. You must not drive yourself.
- Some people may experience numbness or an inability to walk for a short time after the procedure. If this occurs after your procedure, a wheelchair can be provided to assist you to the car.