Epidural-steroid Injections

What Are Epidural Steroid Injections?

An epidural steroid injection delivers a combination of a local anesthetic and a corticosteroid into the epidural space of the spine. This space, located just outside the dural membrane, surrounds and protects the spinal cord and nerves. By reducing inflammation and swelling in the affected area, these injections provide rapid and significant pain relief.

Conditions Treated with Epidural Steroid Injections:

• Herniated Disc: When the inner material of a disc bulges out and compresses a spinal nerve.
• Spinal Stenosis: Narrowing of the spinal canal or nerve root canal, causing nerve compression.
• Sciatica: Pain radiating along the sciatic nerve, often down the leg.
• Degenerative Disc Disease: Aging or breakdown of spinal discs, leading to pain and instability.
• Spondylolisthesis: Slippage of one vertebra over another, causing nerve compression and discomfort.

These injections are commonly recommended for patients whose pain persists despite conservative treatments such as physical therapy and anti-inflammatory medications.

Benefits of Epidural Steroid Injections

Epidural steroid injections not only offer pain relief but also serve diagnostic and therapeutic purposes:

• Pain Reduction: Significant relief lasting three to six months or more, depending on the individual and their condition.
• Diagnostic Insight: Helps determine whether nerve inflammation is the source of pain.
• Facilitates Healing: Provides relief, allowing patients to begin or continue physical therapy.
• Time to Prepare for Surgery: Temporarily eases pain for patients awaiting other treatments.

When administered by skilled physicians, these injections can lead to substantial improvements in quality of life.

What to Expect During the Procedure

Preparation:

Before your appointment:

• Arrange for someone to drive you home, as it is unsafe to drive post-procedure.
• Share your full medical history with your doctor, including all prescription medications, over-the-counter drugs, and supplements.
• If you are on blood thinners (e.g., Coumadin, Plavix, or Eliquis), consult with your prescribing doctor about temporarily stopping them.
• Notify the office if you are pregnant, allergic to contrast dye, or have been recently ill or on antibiotics.
• Follow specific pre-procedure instructions, such as avoiding food and drink for six hours before the procedure.

During the Procedure:

1. Positioning: You will lie on your stomach or a specialized fluoroscopy table.
2. Site Preparation: The doctor will mark and sterilize the injection site.
3. Guidance: Using a live x-ray (fluoroscopy), the physician precisely guides the needle to the epidural space.
4. Medication Delivery: After confirming proper placement with contrast dye, the anesthetic-steroid mixture is injected.

The procedure typically lasts 15–30 minutes, followed by a brief monitoring period.

Routes of Administration:

• Transforaminal: Through the openings between vertebrae.
• Interlaminar: Between the vertebrae.
• Caudal: At the base of the spine, near the tailbone.

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The choice of approach depends on the location and nature of your pain.

After the Procedure: Recovery and Results

Immediate Care:

• Rest for the first 24 hours; avoid strenuous activities.
• Apply ice to the injection site if soreness occurs.
• Most patients can return to work and normal activities the following day.

Expected Outcomes:

• Pain relief may begin within 48 hours but could take up to two weeks for full effect.
• Relief typically lasts three to six months, though this varies by individual.
• Some patients require multiple injections for sustained relief.

Common Side Effects:

• Temporary soreness at the injection site.
• Mild flushing, sweating, or rash.
• In rare cases, a “pins and needles” sensation.

Contact your physician immediately if you experience unusual symptoms like fever, sharp pain, or severe headaches after the procedure.

Safety and Risks

Complications from epidural steroid injections are rare but may include:

• Infection: Prevented by sterile technique.
• Bleeding: Rare but more likely in patients on blood thinners.
• Spinal Headache: Occurs in less than 1% of cases if spinal fluid leaks.

Discuss any pre-existing conditions or concerns with your doctor to minimize risks.

Why Choose Precision Care?

At Precision Care, we believe pain management is personal. Our experts prioritize your comfort and well-being, offering:

• Comprehensive evaluations to identify the root cause of your pain.
• Evidence-based treatments tailored to your specific needs.
• Compassionate, patient-centered care.

Our goal is to help you regain control of your life by alleviating pain effectively and safely.