Epidural Steroid Injection

The epidural steroid injection is a procedure where a long acting steroid solution is administered into the epidural space or near the nerve as it exits the spinal canal.  The procedure is done under fluoroscopy (live X-ray) to deliver the medication to the precise location. Epidural steroid injections can reduce inflammation of the nerves and provide pain relief. The procedure takes approximately 10-15 minutes. 

How should I prepare for the procedure?

Unless otherwise instructed, you may eat, drink, and take your normal medications. You should stop taking any blood thinners as previously instructed. After the procedure, you will be required to have someone drive you home.

Risks and side effects

Usually the procedure is safe. However, with any procedure, there are risks involved. The risks, side effects, and complications vary depending upon where the epidural was done (cervical, thoracic, or lumbar). Anytime the skin is punctured, there is a risk of infection and soreness. To prevent this, sterile conditions will be used. In addition, one may develop temporary numbness if local anesthetic was used. If there is spinal fluid leakage, a spinal headache could occur. Bleeding in the soft tissues or the spinal canal may occur in rare occasions. Injection or bleeding in the spinal canal may lead to neurologic damage. However, all the complications are extremely rare.

How is the procedure done?

The procedure is done under fluoroscopy (live X-ray guidance). A local anesthetic is injected into the skin and tissues below prior to the placement of the epidural needle. The epidural needle is advanced using X-ray guidance into the epidural space. Proper position of the needle is confirmed by injecting a special dye. We will not use dye if the patient has an allergy to dye. After confirming the needle location, we will inject the steroid solution. 

What should be expected after the procedure?

Immediately after the procedure, you may have pain relief. Sometimes patients feel numbness in the legs depending upon what procedure was done. Four to six hours after the local anesthetic wears off, the pain may come back. The pain may even get slightly worse for a couple of days. You may not see improvement in your symptoms until 3-5 days after the injection, when the steroid medication starts to take effect. You should limit your activity after the injection. The next day normal activity may be resumed.