When the spinal nerves have been irritated, we employ a method of injecting a steroid or anesthesia into the epidural space. Your spinal cord is protected by the dural sac and the epidural space is between the outside of the dural sac and the bones of the spine. Spinal nerves pass through this space. This steroid (anti-inflammatory medication) or anesthesia (numbing medication) can bring relief to the pain you are experiencing. During an Epidural Steroid Injection, our physician may inject into the epidural space from behind. This is called an Interlaminal Injection. When the physician goes in from the side, it is called a Transforaminal Injection. If the needle is positioned next to an individual nerve root, it is called a Selective Nerve Root Block. When performed from below it is called a Caudal Injection.
This simple procedure is done by the doctors at Tristate Multi-Specialty Medical Services PC on an outpatient basis and the process is carefully monitored start-to-finish by our medical staff. To begin, the area of the injection will be cleansed and numbed. During the injection, you may feel some pressure or pain, similar to your usual pain, but this means that our doctor is working in the correct source location of your pain. You can expect this pain to go away quickly.
This entire process normally takes 10-15 minutes. Upon completion, you will continue to be monitored and your doctor will determine when you are able to go home.
When you are ready to leave, the nurse will give you discharge instructions. You will also be given a pain diary. It is important to fill this out because it helps your doctor know how the injection is working. It may help to move your back in ways that hurt before the injection, to see if the pain is still there, but do not overdo it. Take it easy for the rest of the day. You may feel immediate pain relief and numbness for up to six hours after the injection. This tells you the medication has reached the right spot.
Your pain may return after this short pain-free period, or may even be a little worse for a day or two. This is normal. It may be caused by needle irritation or by the steroid itself. Steroids usually take two or three days to start working, but can take as long as a week. You can usually return to work the day after the injection, but always check with your doctor.
Sometimes an injection brings several months of pain relief, and then further treatment is needed. Other times, a single injection brings long-term relief. If your pain is caused by injury to more than one area, only some of your symptoms will be helped by a single injection.
The amount and duration of pain relief varies from person to person and is dependent on many factors including underlying pathology and activity level. Some can have relief that lasts for years, while others have short-term relief. Usually a series of injections, often three, each spaced several weeks apart, are given. It is important to discuss your response to epidural steroids with your physician in order to plan future treatment options.
It is not unusual for the patient to experience some pain from time-to-time during the immediate time following the injection, but usually after 3-7 days the steroid or anesthesia medication will start working.