Epidural Injections

What is it?

An epidural injection is a treatment modality that consists of injecting a dose of corticosteroids into the epidural space, a region of the spine between the dura (a membrane surrounding the nerve roots) and the interior surface of the spinal canal. These injections have been shown to decrease pain and inflammation caused by common spine disorders, like herniates discs, sciatica, and spinal stenosis. They offer substantial and long-lasting pain relief without the pain, expense and recovery time of more traditional surgical interventions. Epidural injections can be performed in the cervical, thoracic and lumbar spine, so this treatment could be right for you regardless of where your back pain is.

How is it performed?

An epidural injection is generally performed under x-ray or fluoroscopic guidance, which allows the physician to precisely guide the needle to the exact spot in the spinal canal where they want to inject the medication. Generally, patients will be given a mild sedative and local anesthetic will be applied to the injection site so that the injection itself is less painful. Using imaging guidance, your physician will then guide the needle through your back and into the epidural space, where they will deliver a dose of local anesthetic and corticosteroids to reduce pain and control inflammation. The procedures take less than thirty minutes and, after a brief period of observed recovery, you are free to go home. While the numbing aspect of the local anesthetic will often provide immediate pain relief, the steroids, which provide longer-lasting benefits, can take two to five days to start taking effect.

How often should epidural injections be performed?

While epidural injections can provide substantial benefits, maximum pain relief is generally only found after a series of two to three injections. This series of injections is typically given over a period of six months, allowing for three to four weeks between each injection. However, some people experience full relief after the first or second injection, rendering additional procedures unnecessary. Generally speaking, epidural injections should be used sparingly to prevent the corticosteroids from disrupting your body’s delicate hormone balance, so somewhere from three to four per year is a good guideline.

What can I expect afterward?

Following your injection, you will likely feel immediate pain relief from the local anesthetic injected alongside the corticosteroids. However, this relief will fade once the anesthetic wears off, and the steroids don’t generally take effect for two to five days, so you may experience a pain relapse. Don’t get discouraged, these injections just take time to really make an impact. In conjunction with complementary treatments like physical therapy, massage and non-opioid medications, many patients go on to experience pain-free lives following epidural injections.

As stated above, these injections are done on an outpatient basis and therefore require very little in terms of recovery. Once you have been discharged from the office or ambulatory surgery center where your injection is performed, you are free to go home and rest. It is advisable to not drive on the day of your injection, rest and get plenty of water. Once you feel up to it, many people find short, low-intensity walks can help the recovery process.

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