Epidural Steroid Injection

Epidural steroid injections (ESIs) have been found to be very effective in relieving pain. A steroid is a potent, anti-inflammatory agent that, when injected into the epidural space surrounding the spinal cord and spinal nerves, may reduce the swelling of these nerves and the pain which often accompanies a back or neck disorder.

Preparing For Your Epidural Steroid Injection

Do not take any aspirin or aspirin-containing products including Alka Seltzer, Anacin, Bufferin, and Empirin for one week prior to your appointment. Also, do not take Darvon, Naprosyn, Voltaren, Indocin, or any products containing ibuprofen including Advil and Motrin for one week prior to your appointment. You may take Tylenol.

Notify your physician if you regularly take a blood-thinning medication including aspirin or Coumadin, or if you develop a fever, an infection on any part of your body, or flu symptoms before your scheduled appointment.

What To Expect

When you arrive at the Pain Clinic, a nurse will escort you to an examining room and ask you to disrobe and put on a hospital gown. The nurse will then ask you to sit on the edge of a hospital cart with your feet resting on a chair in front of you. In preparation for your injection, you will be asked to lean forward and bring your elbows to your knees.

The anesthesiologist will then cleanse your back or neck with a sterile solution and inject a local anesthetic into the appropriate area, which may cause momentary discomfort and a slight burning sensation.

After the area is numb, the anesthesiologist will insert a needle through the skin into the epidural space that surrounds the spinal cord and spinal nerves, and inject the steroid. You will feel pressure, but no pain, while the anesthesiologist injects the steroid. The nurse will then place a small adhesive bandage on the injection site and check your blood pressure and pulse.

Some patients experience feelings of anxiety while undergoing this procedure. If you experience such feelings, your blood pressure and pulse may become slightly irregular. If so, the nurse will continue to monitor you for approximately 30 minutes while you sit or lie down. This short period of rest will help your blood pressure and pulse return to normal. The epidural steroid injection procedure takes approximately 15 to 30 minutes to complete.

After Your Injection

You may resume your normal activities immediately following the procedure. You may drive yourself home, although some patients are more comfortable allowing someone else to do so. You may experience some soreness at the injection site for the first 24 hours after receiving your epidural steroid injection. If so, applying ice will help reduce your discomfort.

If you are currently undergoing physical therapy, you can resume your stretching and strengthening exercises immediately after receiving your injection, unless your physician or physical therapist advises you otherwise.

The day after you receive your injection, you may remove the small adhesive bandage and wash the injection site with soap and water. If you experience a headache, or redness, swelling, tenderness, or warmth at the injection site, notify your physician.

Commonly Asked Questions

Will the epidural steroid injection correct my back or neck disorder?

The epidural steroid injection will not correct a structural abnormality in your back or neck. It may, however, reduce the pain and swelling associated with your disorder.

Will I receive more than one epidural steroid injection?

One epidural steroid injection provides long-lasting pain relief for many patients, especially those who are undergoing physical therapy and are diligent about observing good posture. It can take six to 10 days before you begin to respond to the steroid. If you experience complete pain relief after one injection, you will not undergo additional injections. Pain relief can last for many months or years.

If you do not respond to the first injection, a second injection will be administered about two weeks after your first injection. If there is no improvement after two injections, your physician may suggest alternative treatments.

Is the steroid used for an epidural steroid injection the same steroid that some athletes abuse?

The steroid, depomedrol, is similar to the type of steroid your own body produces. It is not the same type of steroid used illegally by some athletes.

Are there any complications associated with an epidural steroid injection?

The epidural steroid injection has a long history of safe use. There is only a 1 percent chance that you will suffer from a brief headache after receiving an epidural steroid injection. Also, whenever skin is punctured, there is a slight chance it may become infected, resulting in redness, swelling, tenderness, or warmth at the injection site.

If you experience a headache or develop an infection at the injection site, immediately notify your physician.