What Are Epidural Steroid Injections?

Your doctor has decided that you need an Epidural Steroid injection. An Epidural Steroid injection is the placement of a cortisone medication around the spinal cord, in an effort to reduce the pain and inflammation caused by nerve irritation. The steroid is placed near the spinal cord and reduces inflammation of the spinal cord and nerve roots that are irritated by such things as herniated discs or spinal stenosis (pinched nerves). Epidural Steroid Injections are often given in a series depending on your particular needs.

What are they used for?

Epidural injections are given thousands of times a day in the U.S. to provide pain relief. These injections treat many different types of pain. Epidural injections are performed for surgical operations by an anesthesiologist. They are used often for labor and delivery during pregnancy. They can provide temporary and long term relief from the pain caused by nerve root compression (sciatica), spinal stenosis (pinched nerves), shingles or post herpetic neuralgia, compression fractures as well as pain from reflex sympathetic dystrophy.

How is the epidural injection performed?

At the Palm Beach Spine & Diagnostic Institute, all of the epidural injections are performed using an x-ray fluoroscopy machine. During the procedure, your heart and blood pressure will be monitored. An IV will be started and you may have mild sedation if you want. The actual epidural takes about ten minutes to perform. You will be lying prone on your abdomen during the procedure. Your back will be cleansed with a sterilizing solution, and a Novocain injection will numb your back. You should only feel pressure after the Novocain is injected. It is important that you do not move during the procedure, but you will be able to talk if anything bothers or hurts you. The procedure should not hurt. After the injection is completed, you will be observed for at least a half-hour, before you go home. You must have someone drive you home after the procedure.

What are some side effects of this procedure?

Side-effects and complications are rare, but they do occasionally occur. Bleeding is a serious complication, which may occur if you are taking aspirin, anti-inflammatory medications, blood thinners or anticoagulants and vitamin E. Sometimes your legs can get numb for a short period of time after the injection. This numbness is temporary and wears off after an hour or so. Infection can also be a serious complication. Please inform the doctor or nurses if you have a cold or infection elsewhere in your body. Headache, red face, increased or decreased appetite and mild fluid retention do occasionally occur, but last for only several days. Please review carefully the full list of possible complications on the consent form, including very rare nerve damage, paralysis and allergic reactions.

What are steroids?

Steroids are chemicals that your body makes naturally. They circulate in the bloodstream and have multiple functions including combating stress and combating inflammation. The kind of steroids we us at the Palm Beach Spine & Diagnostic Institute are anti-inflammatory in nature and are not the kind that athletes use to build muscle. Anti-inflammatory, cortisone steroids are the type of steroid used for Epidural Steroid Injections.

What do I need to do to prepare for the injection?

There is no special preparation for this procedure. You may have a light breakfast or lunch before your procedure. The nurses at Palm Beach Spine & Diagnostic Institute will give you a list of medicines that you should stop taking before you get the injection. If you are not sure about a medicine you are taking, please ask one of our nurses.

What happens if the shots don't work?

If you have little pain relief from your Epidural Steroid Injections, we will reevaluate your medical status and consider other treatments. Back pain and some of the other pain syndromes treated with Epidurals are often complex. There may be multiple causes of your pain and these will be considered and evaluated. If your pain persists following your injections, call our nurses and a follow-up appointment will be scheduled.