Epidural Steroid
The Pain Management Center at Saint Anthony's Health Center offers epidural steroid injections to treat nerve inflammation, which can cause neck, arm, back or leg pain.
The membrane that covers the spine is called the dura. The space that surrounds it is the epidural space. When the nerves that travel along the dural membrane become inflamed it becomes quiet painful.
An epidural steroid injection involves an injection of steroidal medication to the epidural space reducing the swelling of the nerve roots. Usually a total of (3) epidural injections are given a couple of weeks apart. Although the epidural injection may not provide permanent pain relief, it may provide relief for several weeks or months while the injury/cause of pain is healing.
PROCEDURE TIME
The exam lasts 40 minutes.Most exams require the patient to remain at Advanced Pain Management 30 minutes post-procedure.
Epidural steroid injections provide diagnostic data and pain relief by delivering local anesthetic and anti-inflammatory steroid medications onto the surface of the spinal column. This procedure addresses inflammation resulting in long-term pain relief while it provides valuable information on the source of the patient’s pain.
Patients will be awake throughout the test. A radiologist will position a thin needle in his/her spine, guided by fluoroscopy connected to a television monitor. X-ray contrast material will then be injected and x-rays taken. The medication will be injected next, which may create a pressure sensation. Along with steroidal medications such as Depomedrol or Kenalog, numbing medication just like the ones used by your dentists to numb up your gums will be injected into the epidural space.
If you are taking any blood thinners such as Coumadin and Plavix, you must stop taking them 1 week before your injection. Let your primary care doctor and Pain Management Center know before you stop taking your blood thinners.
Before the procedure you will be placed on your stomach and your back or neck will be prepped with a solution which will kill the germs, creating a sterile area for the injection site. Your back/neck will be numbed with local anesthetic at the site before the insertion of the small needle.
Once the numbing medication wears off, your pain will likely return. The steroid medication will provide longer lasting pain relief, but probably won’t begin working for 24 to 48 hours after the injection. We hope the injections relieve your pain, but there are no guarantees that they will.
You may experience bruising or tenderness at the injection site(s), and the application of ice to the area may help.
Side effects of the steroid medications-- which affect only 5% of patients and disappear within 1-3 days-- include facial flushing, insomnia, and occasional low grade fever.
Due to the effects of certain medications, the patient’s driving reflexes may be impaired. Consequently, he/she should arrange for a driver in advance.
Q: How will the patient feel after the procedure?
A: Patients may experience numbness and/or relief from symptoms for up to six hours after the injection. The usual symptoms may then return and may possibly be worse than usual for a day or two.
Q: When will the pain relief medication take effect?
A: The beneficial effects of the steroids usually require 2-3 days to take hold. If there is no change in the patient’s symptoms after a week, investigation into other potential sources of pain may be warranted.
Q: Would additional injections increase the patient’s relief?
A: If an initial injection provided a certain amount of relief, a second injection might strengthen the pain relief effect. Also, if the patient’s pain subsides, but begins to return weeks or months later, additional injections up to four a year are possible.
For more information on Saint Anthony's Center for Pain Management, please call: 618/474-4866.