What is an epidural steroid injection?

August 5, 2019

epidural steroid injectionsAn epidural steroid injection is a minimally invasive procedure used to treat back, neck, leg, and arm pain caused by inflamed spinal nerves due to spinal stenosis or disc herniation. The injection of medication into the epidural space can help alleviate this pain with the primary goal to reduce discomfort so that you may resume normal activities and begin a physical therapy program.

Epidural steroid injection procedure

Epidural space is the area that sits between the vertebrae and the spinal sac. This fat-filled area is targeted with steroids often in combination with anesthetic. 

To prepare for an epidural steroid injection, you will start by lying down. We cleanse the injection site and numb it with local anesthetic. You will remain awake throughout the procedure so that you can provide feedback to your physician, and a low dose of sedative may be administered as a calming agent if needed. Discomfort should be minimal.

With x-ray fluoroscope guidance, your physician will direct a hollow needle through the skin and between the bony vertebrae into the epidural space. The physician then injects a contrast dye to ensure placement is correct, and the targeted area is injected with the steroid mixture. Some discomfort may occur, but patients most commonly feel pressure rather than pain.

The average procedure takes 30 minutes. This will vary according to the number of injections needed and the in-office recovery period required by your physician. 

The best candidates for epidural steroid injections

Patients with pain in the neck, arm, low back, or leg pain may benefit the most from epidural steroid injections. If you suffer from one of the following conditions, you may be a good candidate:

  • Spinal stenosis — Narrowing of the spinal canal and nerve root canal causing back and leg pain, especially when walking.
  • Spondylolisthesis — Weakness or fracture between the upper and lower facets of a vertebra. If the vertebra slips forward, it can compress the nerve roots causing pain.
  • Herniated disc — The gel-like material within the disc can bulge or rupture through a weak area in the surrounding wall. Irritation, pain, and swelling occur when this material squeezes out and comes in contact with a spinal nerve.
  • Degenerative disc — The breakdown or aging of the intervertebral disc causing collapse of the disc space, tears in the annulus, and growth of bone spurs.
  • Sciatica — Pain that courses along the sciatic nerve in the buttocks and down the legs, usually caused by compression of the 5th lumbar or 1st sacral spinal nerve.

What to expect after epidural steroid injections

For those candidates listed above who do undergo epidural steroid injections, it is usually possible to walk immediately after the procedure. After being monitored for a length of time determined by your doctor, we require that you have someone drive you home as a precaution. You may experience side effects such as soreness at the injection site, trouble sleeping, hot flashes, and water retention. Typically patients are able to resume full activity the day after the injection. 

Over the next few weeks, we advise that you record your levels of pain in a journal. You may notice a slight increase in pain, numbness, or weakness as the numbing medicine wears off but before the corticosteroid starts to take full effect. It can be beneficial for us to have a record of this kind of information to determine how well your injections worked.

Many of our patients do experience beneficial pain relief. For those who experience only mild pain relief, we can perform one or two more epidural steroid injections over a period of one to four weeks. This, combined with physical therapy and an appropriate home exercise program, can produce significant results for pain relief. 

Southside Pain Specialists is your one-stop shop for pain management

With a multitude of pain relief options tailored to your specific needs, Southside Pain Specialists follow the standards of the American Society of Interventional Pain Physicians, The American Board of Pain Medicine and the International Spinal Injection Society and works hard to provide patients comprehensive, caring pain relief when they need it most. Check out our website or contact us today at 205.332.3155 to learn more.