Epidural steroid injection

Epidural

steroid

injection

Epidural Steroid Injection

If you’re experiencing chronic back &/or leg pain, or neck &/or arm pain, an epidural steroid injection (ESI) may be a treatment option to help relieve pain and inflammation.

What Is an Epidural Steroid Injection?

An epidural steroid injection (ESI) is a minimally invasive procedure used to relieve pain caused by degeneration of discs, and inflammation around spinal cord and nerve roots. The injection involves delivering a corticosteroid (a powerful anti-inflammatory medication) and sometimes a local anesthetic into the epidural space around the spinal cord. This helps reduce inflammation and can alleviate pain in the back, neck, legs, or arms.

ESIs are often used to treat conditions like:

Herniated discs
Spinal stenosis
Sciatica
Degenerative disc disease
Spondylolisthesis

Is an Epidural Steroid Injection for Me?

An epidural steroid injection may be recommended if:

You have been diagnosed with conditions such as herniated discs, spinal stenosis, or sciatica that cause nerve inflammation and pain.
Conservative treatments like medication, exercise, or physical therapy have not provided sufficient relief.
Your pain significantly affects your daily activities, mobility, or quality of life.

Dr. Gilthorpe and associates will assess your medical history, symptoms, and diagnostic imaging (such as MRI or CT scans) to determine if an epidural steroid injection is appropriate for you.

What Are the Benefits of Epidural Steroid Injections?

The primary benefits of epidural steroid injections include:

Pain relief: The corticosteroid reduces inflammation around the irritated nerves, leading to reduced pain in the back, neck, arms, or legs.
Improved mobility and function: By alleviating pain, you may experience improved mobility and function, allowing you to engage in daily activities more easily, with less discomfort.
Non-surgical: ESI is a minimally invasive alternative to surgery for managing spine-related pain.
Diagnostic tool: An ESI can also help confirm the source of pain by targeting specific areas of the spine.
Quick recovery: Most patients experience little downtime and can resume normal activities soon after the procedure.

What Are the Risks of Epidural Steroid Injections?

While epidural steroid injections are considered safe, there are some potential risks to consider:

Temporary increase in pain: Some patients may experience increased pain or discomfort at the injection site shortly after the procedure.
Bleeding: Rarely, bleeding may occur, especially in patients with bleeding disorders or those on blood thinners.
Infection: There’s a very small risk of infection at the injection site.
Nerve damage: While extremely rare, there is a risk of damaging nearby nerves.
Headache: A headache can occur from the medications used, or if the needle punctures the dura causing a spinal headache.
Allergic reaction: Although rare, some patients may experience an allergic reaction to the medications.

How Do I Prepare for an Epidural Steroid Injection?

Preparing for an epidural steroid injection involves a few important steps:

Please call and reschedule if you have an active infection
Wear loose, comfortable clothing that allows easy access to your back or neck
Inform Dr. Gilthorpe of the following:
- Allergies, or medication sensitivities
- IV contrast allergy or sensitivity; or kidney disease
- If you have diabetes, especially if it’s difficult to control
- If you take blood thinners (such as clopidogrel/ Plavix, ticagrelor/ Brilinta, apixaban/ Eliquis, warfarin/ Coumadin, rivaroxaban/ Xarelto, enoxaparin/ Lovenox, heparin, or others)
Blood thinners will need to be held prior to your epidural steroid injection
- Dr. Gilthorpe’s office will reach out to the prescribing physician to clearance to hold blood thinners
Fasting is NOT necessary for injections completed in the clinic
A driver is NOT necessary for injections completed in the clinic. However, if you have significant weakness after the injection (which is rare), you will need to avoid driving for 6 hours. In which case you will need to stay at the clinic, or arrange transportation.

What if my epidural steroid injection is scheduled in the hospital?

Epidural steroid injections are typically scheduled in the clinic, but in limited circumstances, they may be scheduled in a hospital or surgical center. If your epidural steroid injection is scheduled at a hospital:

You need to fast (including food and water) after midnight, the night before
A responsible adult needs to accompany you to drive after anesthesia.
The hospital will contact you to:
- Give you an arrival time
- Let you know if any preoperative testing is necessary prior to anesthesia

How Is the Epidural Steroid Injection Performed?

An epidural steroid injection typically takes 15 minutes, and is performed on an outpatient basis. Here’s what to expect:

Safety-Check: Your vitals will be checked and the procedure site will be confirmed.
Positioning: You will lay face down on an X-ray table. You may be asked to change into a gown if the area is not easily accessible.
Cleansing the area: The skin around the injection site will be cleaned with antiseptic to minimize the risk of infection.
Draping: A small drape with be placed over the area to maintain sterility
Fluoroscopy (X-ray guidance): Dr Gilthorpe will use fluoroscopy, a type of real-time X-ray, to guide the needle into the epidural space.
Local anesthesia: A local anesthetic is used to numb the area where the injection will be given.
Injection: Once the needle is correctly positioned, the medication is injected into the epidural space.
Band aid: A band aid will be placed over the site.
Monitoring: After the injection, you will be observed for a short time (about 20 minutes) to ensure there are no immediate complications.

Post-Procedure Care and Restrictions

After an epidural steroid injection, you can usually return to normal activities with a few precautions:

If you have significant weakness after the injection (which is rare), you will need to avoid driving for 6 hours. In which case you will need to stay at the clinic, or arrange transportation.
Rest for the first 24 hours: Avoid strenuous activities or heavy lifting for about a day.
Mild soreness at the injection site is common. Placing ice over the injection site for no more than 20 minutes at a time can help relieve this soreness.
Steroid side effects: You may experience hot-flashes or flushing, mild headaches, or insomnia for a few days.
Serious side effects are very rare

But if you have any of the following, you should go to an Emergency Room.
New weakness and numbness after the initial weakness and numbness wore off; or persistent weakness over 24 hours.
Severe swelling, redness, or drainage at the procedure site.
New urinary incontinence.
High fever.

How long will an epidural steroid injection last? How often is it done?

Relief can begin within a few minutes, but usually takes a day or two, and full effects may take up to two weeks.
Relief from epidural steroid injections varies. Some patients experience relief for several months or more, while others may need additional injections.
Repeat injections may be necessary, but are usually spaced about 3 months apart to minimize potential side effects.

Frequently Asked Questions (FAQs) About Epidural Steroid Injections

Q: Will the injection cure my condition?

A: Epidural steroid injections are designed to manage pain and reduce inflammation. They cannot cure herniations, but they can help decrease pain while the body heals, or as part of a comprehensive treatment plan that may include exercises, physical therapy, or surgery

Q: Is the injection painful?

A: Some patients experience mild discomfort during the injection, but local anesthesia (numbing medicine) is used to minimize pain. You may also feel pressure as the medication is injected.

Q: Do I need time off work after the procedure?

A: Most patients can return to work the following day, especially if their job does not require heavy lifting or strenuous activity.

Summary

An epidural steroid injection can be an effective treatment for managing chronic back, neck, leg or arm pain caused by conditions like herniated discs, spinal stenosis, or sciatica. It’s a minimally invasive procedure that offers pain relief and helps improve your quality of life.

For more information or to schedule a consultation, [request an appointment here] or call us at 832-286-4546.