Epidural Steroid Injection

An epidural steroid injection is a procedure to help relieve pain. It works by reducing the inflammation of irritated nerves within the spinal canal. These nerves can be irritated as a result of a herniated cervical disc or because of arthritis of the spine. The discs are “cushions” between the vertebrae that can degenerate as a result of injury or advanced age. When a disc loses its integrity, it can not only spill irritating chemicals on to spinal nerves, but it can also cause direct pressure effects. Arthritis causes nerve irritation because this degenerating process narrows the canals where the nerves lie.

An epidural steroid injection is very safe; its potential benefits include decreased pain, decreased numbness and/or tingling, and increased mobility. As with any procedure, there are risks involved, such as infection, bleeding, nerve injury, and worsened pain. There are also possible side effects relating to the steroid itself. These include blood sugar increases, weight gain, water retention, and suppression of the body’s own production of cortisone.

The procedure is performed at an outpatient surgery center. Usually, an IV (intravenous) line is started pre-operatively in order to give you a mild sedation. You are then brought to the procedure suite and placed in the prone (face down) or seated position. Your skin is cleansed with an antiseptic solution, and drapes are placed to maintain a sterile field. To be as precise as possible, the physician uses an x-ray machine to visualize your spinal anatomy. Next, your skin and subcutaneous tissues are anesthetized with a local anesthetic. An epidural needle is then inserted and advanced to the area surrounding the spinal cord and the nerves coming out of it. Contrast “dye” may be used to assure proper needle position as it outlines the intended target. During the injection of steroid, you may feel slight discomfort from the pressure effects of the injected solution. After the procedure is over, you are taken to the recovery area for approximately 30 minutes before being discharged.

After the procedure, there may be some slight discomfort from the mechanical process of needle insertion or from pressure effects from the solution. Usually, the procedure is very well tolerated, and most patients can resume their normal activities the next day. The steroid takes approximately 1–2 days to take effect, so you should not expect immediate relief. Furthermore, it is not uncommon for it to take 2 or 3 epidural steroid injections to obtain the most benefit.

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