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Epidural & Back Injections
What is an Epidural Injection?
An epidural injection is delivered into the epidural space of the spine to provide temporary or prolonged relief from pain or inflammation. Steroids, anesthetics and anti-inflammatory medications are typically administered. The injection reduces pain and swelling in and around the spinal nerve roots.
Fluoroscopy or computed tomography are used to help the doctor place the needle in the right location so the patient can receive maximum benefit from the injection.
What are some common uses of the procedure?
An epidural injection may be performed to alleviate pain caused by:
How should I prepare for the procedure?
You will receive specific instructions on how to prepare, including any changes that need to be made to your regular medication schedule.
You may be instructed not to eat or drink anything for several hours before your procedure.
You may be asked to wear a gown during the procedure.
You will probably be asked to use the restroom before the procedure.
You will then be positioned on your stomach or side on a special fluoroscopic or CT table that will give the doctor easy access to the injection site(s). The nurse will help to make you as comfortable as possible, both during and after the procedure.
You should plan to have a relative or friend drive you home after your procedure.
How is the procedure performed?
An epidural injection usually takes only minutes to administer.
When you arrive, the nurse may place an intravenous (IV) line in your arm to deliver a relaxation medication during the procedure. You will be situated on your stomach or on your side, on a table in the fluoroscopic room or in computed tomography room and made to feel as comfortable as possible.
The doctor will identify where the injection should be given and will sterilize the skin with an antiseptic solution. He or she will then inject a local anesthetic to help numb the area before administering the epidural injection.
Once the area is numb, the doctor will most likely use imaging guidance to help guide the epidural needle to exactly the right position. When the needle is in place, a contrast material will be injected so the doctor can ensure the distribution of the medication given. Then, your doctor will slowly inject the medication, which is typically a combination of anesthetic and anti-inflammatory drugs (cortisone/steroids).
When finished, you will be moved into a chair or bed and allowed to rest for a few minutes to an hour. The nurse will make sure you do not have any unfavorable reactions to the medication before you are allowed to leave.
What will I experience during the procedure?
You may have no sensation whatsoever, however you may feel tingling or pressure when the injection is administered. Depending on the amount of swelling in the area, you may experience a burning sensation or some mild discomfort as the medication enters the epidural space. When the injection is finished, however, any discomfort usually disappears. It is possible to feel "pins and needles" in your arms and legs, depending on the injection site. If you feel any sharp pains, however, tell your doctor immediately.
Due to the numbness and any discomfort you may experience after the procedure, you may have some difficulty walking on your own and getting in and out of the car. This is normal and should subside in a matter of hours. You should take it easy for the rest of the day, though, and may resume normal activities the next day.
The epidural may not take effect immediately-it is common for improvement in the pain to occur progressively over the first 48 hours. The effects may last for a matter of days, weeks, and occasionally months.
Facet Joint and Sacroiliac Joint Injections
What are these injections?
Facet joint and sacroiliac joint injections are a conservative treatment option for back pain. They can be used to treat back pain after a course of medications, or before physical therapy is completed, and possibly before surgery is considered. These injections can be useful in providing palliative pain relief and as a diagnostic tool to help in identifying the source of the pain. The goal is to reduce or alleviate the pain.
Will this work if oral pain medications do not?
Injections can be more effective than an oral medication because they deliver medication directly to the anatomic location that is generating the pain. A long acting anesthetic and steroid medication is injected to deliver a powerful anti-inflamatory solution directly to the area that is believed to be the source of pain. Depending on the type of injection, some forms of pain relief may be long lasting while some may only be temporary.
Who will perform this procedure?
A radiologist will explain and answer questions before the procedure and then will perform the procedure. Expect to be at our facility 45 minutes to 1 hour.
When can I resume normal activities?
Normal activity can resume as soon as tolerated.
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