Epidural Steroid Injection | Pain Management | Dartmouth-Hitchcock
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Epidural Steroid Injection

Illustration: Epidural Steroid InjectionWhat is an Epidural Injection?
An epidural injection is an injection of steroid into the epidural space. The epidural space is a space located in the spine between the vertebrae and the dural sac, which surrounds the spinal cord.

What is the purpose for it?
Theoretically, the steroid reduces the inflammation of the nerve roots as they exit the spine.

How much time does the procedure take?
The procedure takes approximately 15 minutes.

What medicine is injected?
Usually steroid, although sometimes a mixture of local anesthetic and steroid will be injected.

Will the injection hurt?
The procedure is performed under local anesthetic, which is used to numb the skin and deeper tissues. You may feel some pressure during the procedure but not much pain.

How is the injection performed?
The procedure is performed under x-ray guidance. The patient is lying on her/his stomach. The blood pressure, heart rate and blood oxygenation are monitored. The skin is cleaned with antiseptic solution. The local anesthetic is used to numb the skin and then the injection is performed.

How will I feel after the injection?
You may have a sore back after the injection for a few days. Using an ice pack three or four times a day will help this. If local anesthetic is injected into the epidural space you may experience weakness or numbness in the legs for a few hours.

How long does the effect of the injection last?
The steroid starts having an effect in one to five days. The effect can last for several days to a few months or longer.

How many injections can I have in a year?
The number will depend upon the cause of your pain and whether or not you have other health issues problems.

What are the side effects of the injection?
Initial side effect is local soreness from the injection. Late side effects are related to the steroid. Steroid may elevate blood sugar. Patients prone to fluid retention may experience that.

What are the complications of the procedure?
The most common complication is dural sac puncture, which could cause headache. The other complications are bleeding and infection, but these are rare. Very uncommon complications include nerve or spinal cord injury.

Who should not have this injection?
If you are taking blood thinners (Coumadin, Plavix, Ticlid or others) or antibiotics, have an active infection, or have a bleeding disorder you should not have the procedure without further discussion. Please warn us of any allergies you have, especially to local anesthetics, X-ray dye and latex.

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