What is an epidural injection?
The term epidural translates as “around the spinal cord.” Thus, an epidural injection is administered in the region around the spinal cord. This procedure is commonly used to treat nerve and back pain. An epidural injection is used to introduce a painkiller into the area that is creating the pain.
Why would my doctor recommend that I have an epidural injection?
Usually epidural injections are used when a patient’s low back pain has not improved, or it has become worse. This treatment is often recommended when painkillers, physical therapy, and other nonsurgical measures used to reduce or eliminate pain have been unsuccessful. The procedure is utilized in cases that involve disc herniation in which pain spreads down the lower spine and radiates into the hips or down the leg.
A bulging disc putting pressure on a nerve most often causes this pain. The medicine in the epidural injection reduces inflammation and pressure on the larger nerves located in the vicinity of your spine, helping to decrease or eliminate pain.
In what way can epidural injections be used to treat back and nerve pain?
The substance that is injected into the area to be treated is a prescribed painkiller. The process allows for the injection of a powerful agent directly into the damaged area, targeting the pain and easing it directly. This technique is much more efficient and effective that prescribing generalized pain relievers that are taken orally.
How do they know where to inject the painkiller?
A few days prior to your procedure, and after being examined by your doctor, imaging (MRI or CT) will be performed on the general area to be treated. The results of your imaging test will be used to determine exactly where the source of your problem lies and where the injections will be made.
What types of painkilling agents are used?
Commonly epidural injections utilize steroids, which have been used successfully to treat back pain.
What will the doctor need to know prior to treatment?
At least a few days prior to the procedure, you will be asked the following questions:
- What prescription and nonprescription medicines you are taking?
- What herbs or supplements you are taking?
- Are you pregnant or might you be pregnant?
If you are taking medicines that may make it difficult for your blood to clot, you may be asked to stop taking them several days before you undergo the epidural injection. Drugs that you may need to cease taking in order for the procedure to be performed include aspirin, ibuprofen, clopidogrel, warfarin, naproxen, and heparin.
If I receive an epidural injection will my back problem be cured?
No, epidural injections are for pain management purposes. Thus, although you should be able to move about with your pain reduced or completely eliminated, the cause of the pain has not been cured. This does not mean that over time your health issue won’t heal, but it does mean that the purpose of your epidural injection is not directly connected to curing your malady.
Who administers epidural injections?
A doctor administers epidural injections either in their office or at a hospital.
What is the procedure for treatment with epidural injections?
On the day of your epidural injection:
- You’ll lie face down on an x-ray table with a pillow under your stomach (There are alternative positions if this is uncomfortable)
- The area in which the injection will be made is carefully cleaned
- Medicine to help you relax may be administered
- You may be given a local anesthetic to numb the area
- The doctor will insert the needle into your back
- In order to locate the correct spot in your back, the doctor may use an x-ray device that creates real-time images
- The doctor will inject the painkilling agent, which is mixed with numbing agents, into the area
- During the process, it’s important that you stay still in order to ensure the injection is placed in the precise area
- You will then be monitored for about an hour after the procedure before being allowed to go home
Is the process painful?
Most of the time patients feel some pressure when the needle is inserted into the area. This is usually not a painful procedure, and it is not the same procedure as epidural anesthesia, which is administered just before childbirth or prior to certain kinds of surgery.
What should I expect after the procedure is performed?
Patients often feel some discomfort in the area in which the needle was inserted. This feeling usually dissipates after a few hours. Many times patients are told to rest for the remainder of the day. For about two to three days after your epidural injection, your pain may become worse prior to improving.
What are the risks concerning epidural injections?
Overall, epidural injections, which are minimally invasive, are low risk procedures. Complication that may occur include:
- Dizziness, headache, or nausea, which are usually mild
- Damage to the nerve root with radiating pain increasing down the leg
- An infection in or around the spine
- Bleeding in the area of the spine
- Allergic reaction to the painkiller