Epidural Injections

The injection allows us to place a steroid next to an inflamed nerve to attempt to reduce the inflammation and/or swelling of the nerves and make them more resistant to mechanical irritation and improve blood flow to the area. This may reduce pain, tingling and numbness caused by the irritated nerve. All spinal injections are done on an outpatient basis and are performed under fluoroscopic (X-ray) guidance in order to ensure proper placement and to maximize safety and comfort.

Typically, the actual injection takes a few minutes, from 5-10, but expect to spend 45 minutes to an hour at our facility due to preparation and evaluation time. The local anesthetic (lidocaine) starts working in a few minutes and wears off after a few hours. The steroid can take up to 3-5 days to start working and its effects can range from no benefit, benefit for a few days, weeks, months or years. Most patients have good initial relief. In some patients, this pain relief will be lasting, while in others there may be some wearing off of the beneficial effect within weeks or months. However, in the majority of cases, wearing off is only partial and the patient may be left with lasting partial pain relief. We consider these injections successful if a series of three injections can provide relief for six months or longer.

Typically, the actual injection takes a few minutes, from 5-10, but expect to spend 45 minutes to an hour at our facility due to preparation and evaluation time. With all injections, there is a risk of infection, bleeding, temporary increase in pain and injury to the structures along the course of the needle. Through sterile equipment and technique, we minimize the risk of infection. The risk of bleeding is minimized by discontinuation of blood thinners (this typically require approval from the prescribing doctor) and non-steroidal anti-inflammatories (except Celebrex). By using x-ray guidance (fluoroscopy) we minimize risk of tissue injury to structures along the course of the needle. Nerve irritation is minimized by the use of local anesthetic 1 percent lidocaine to provide temporarily relief that typically wears off after 1-2 hours. The steroid medication can take 3-5 days to take full effect, so patients may have increased soreness for a few days after the procedure.

With all injections, there is a risk of infection, bleeding, temporary increase in pain and injury to the structures along the course of the needle. Through sterile equipment and technique, we minimize the risk of infection. The risk of bleeding is minimized by discontinuation of blood thinners (this typically require approval from the prescribing doctor) and non-steroidal anti-inflammatories (except Celebrex). By using x-ray guidance (fluoroscopy) we minimize risk of tissue injury to structures along the course of the needle. Nerve irritation is minimized by the use of local anesthetic 1 percent lidocaine to provide temporarily relief that typically wears off after 1-2 hours. The steroid medication can take 3-5 days to take full effect, so patients may have increased soreness for a few days after the procedure. If you have an active infection, poorly controlled hypertension, diabetes, congestive heart failure or are unable to stop blood thinners, you may not be a candidate for this injection.