An epidural injection is an injection of medication, usually a corticosteroid and anesthetic or narcotic into the epidural space. The epidural space is within the spinal canal between the bony vertebrae and spinal cord. The space is filled with fatty tissue, veins, and arteries. The fatty tissue acts as a shock absorber and barrier to keep the spinal cord from coming into contact with the bony vertebrae.
A corticosteroid is a powerful and long-lasting anti-inflammatory medication that helps to calm irritated and swollen nerve roots and aids healing. The anesthetic or narcotic provides temporary pain relief. Epidural injections can be administered at a clinic, outpatient center, or hospital. Many physician specialists are qualified to perform injection procedures including anesthesiologists, radiologists, neurologists, physiatrists, and spine surgeons.
Spinal epidural injections can be an important part of your diagnostic process and treatment program. Epidural injections offer patients two potential benefits:
Epidural injections may be given to treat cervical (neck and arm) pain or lumbar (back, buttock, and leg) pain when nerve compression or damage is suspected. Pain relief from an epidural injection is often temporary and may last one week to one month. The injection may be of particular benefit during an acute pain episode and provide the patient sufficient relief to participate in physical therapy and/or rehabilitation.
Depending on the outcome of the first injection, a second epidural injection may be administered. If the first or second epidural does not produce good results, seldom is a third injection given. Because a spinal epidural injection includes a steroid (corticosteroid), the number of injections allowed each year is limited to help prevent and minimize steroid-related side effects such as loss of bone density.
An epidural injection, like other medical procedures, may present risks. Complications include bleeding, risk of infection, low blood pressure, headache, injury to nerve tissue, and/or allergic reaction to medication or contrast media.
Some patients should not undergo a spinal epidural injection. Contraindications (restrictions, precautions) include:
The medical staff reviews your history, condition, medications, allergies, and other pertinent information.
Overview: The procedure is performed using fluoroscopy to guide needle placement into the epidural space. Fluoroscopy allows the doctor to see the procedure, similar to real time x-ray. When the needle tip is positioned at the target area, a small amount of contrast agent (dye) is injected into the area to confirm the medication will flow correctly into place. Once confirmed, an anesthetic and corticosteroid medication is injected.