Epidurial Steroid Injection
EPIDURAL STEROID INJECTIONS
What is the purpose of the procedure?
The purpose of the epidural steroid injection procedure is to place a volume of long-acting cortisone around the spinal cord. This is to decrease the inflammation of the nerves. Its goal is to decrease your neck, back, arm, and/or leg pain.
How is it performed?
You will lie on your stomach on a special table, which allows for X-ray viewing of your spine. Your doctor will carefully and slowly anesthetize the injection site and place a small needle in the epidural space (space around the nerves). Often, a small volume of contrast will be injected to make certain the needle is in the correct position. At this point, the cortisone will be injected.
How long does the procedure take?
The procedure takes about five to ten minutes to perform. You may be required to change into a gown and might need to stay a few minutes after the procedure before leaving. It would be best if you did not plan on driving home and had a friend or relative come with you.
What are the risks?
The biggest risk from the procedure is that it will not help you to any great degree. The amount of pain relief you can expect from this procedure is extremely variable and cannot be predicted prior to performing it. The other most common risk would be that the needle is placed into the nerves instead of around the nerves. If this happens, the needle will have gone through the dural membrane, similar to what happens when a myelogram is performed. The problem this presents is that you may develop headaches after the procedure, which could last several days and could even require a second procedure of placing blood from your arm into the area to produce what is called a blood patch. Please ask your doctor any questions you may have about these risks.
How well does an epidural steroid injection work?
This is extremely variable. It cannot be predicted who will benefit or for how long you may benefit from the injection. Often, it is done in an attempt to avoid a surgical approach. We generally perform one epidural steroid injection and would only consider a second if the first one was helpful for a period of time. Some doctors do a series of epidural steroid injections in rapid succession.