Epidural Injections

Why do I need an epidural injection?

When symptoms of pain are the result of spinal problems, an epidural injection may be considered. The pain may be the result of an injury, accident, surgery, or normal age-related degeneration of the spine. The pain can be present in the neck (Cervical Spine), the mid back (Thoracic Spine), or the low back (Lumbar Spine). Different approaches can be used to inject into the spine (Transforaminal, Caudal, Intralaminar). Typically, epidural steroid injections are more commonly used to treat disc herniations and spinal stenosis.


How does an epidural injection work?

When the spine is injured, diseased, or degenerated, mechanical and chemical changes can cause inflammation and swelling of the nerve. The injection of numbing medication (local anesthetic) or saline combined with a steroid can be used to reduce inflammation. This treatment is usually administered in a series of three injections. If relief is not obtained after two injections, other treatment options may be considered.


How is an epidural injection performed?

A number of approaches can be used to perform epidural steroid injections. Which one is used depends on the specific problem. The patient may or may not receive sedation. During this procedure, the patient is positioned on an x-ray table. If fluoroscopy is not deemed necessary or not available, the patient may be positioned in a sitting position at the bedside. The skin is then numbed with a local anesthetic and the needle is inserted in the proper position. Fluoroscopy is used to precisely place the needle.


What are the potential risks?

As with any invasive procedure, there is a risk of infection and bleeding at the injection site. The patient may also experience a spinal headache.


What should I expect following the procedure?

In most patients, pain relief is noted within two to seven days. It is common to have localized pain at the site of the injection for one to five days. There is the possibility that low back and leg pain could increase until the steroids take effect and relief is experienced. This procedure is most effective when combined with other methods to control pain, which may include physical therapy, medication management, weight loss, smoking cessation, and other recommended interventions.