Epidural Injections

Epidural Injections by Dr. Vivek Loomba

An epidural injection is a procedure in which an injection of steroid or corticosteroid is administered into the body’s epidural space. It is a common treatment for different forms of pain such as neck, leg, arm, and back pain caused by spinal nerve inflammation.

Why Epidural injection is performed?

An epidural injection is usually performed if the surgery, physical therapy, or medicines have failed in relieving the pain. It is used to heal the pain in the lower spine of the hips or down the leg. This pain is caused by nerve damage or a bulging disk.

Types of Epidural Injections

Epidural injections are injected on the basis of a person’s disorders and procedures recommended by doctors. The types of epidural injections provided are –

• Transforaminal Epidural Steroid Injection – It is used to treat back pain by inserting a needle between the spine and spinal cord. It reduces inflammation from the back and down the leg.
• Caudal Epidural Steroid Injection – A needle is inserted below the lumbar spine or low back. It is used to relieve pain from disorders such as herniated discs or sciatica (leg pain).
• Interlaminar Epidural Steroid Injection – It is effective in treating back, neck, leg, and arm pain. 

Epidural Injections Procedure Usage

It is widely used in combination procedures to relieve pain along with physical therapy, oral medications, and surgery for potential benefits involved. It is performed on parts for pain related to –

• A herniated or bulging disk
• Spinal stenosis (spinal canal narrowing)
• Bone spurs
• Post-operative failed back surgery syndromes
• Spinal nerves and surrounding tissues injuries

Before the procedure

If your doctor is advising you to take epidural injections you must be aware of the precautions before the procedures are performed. Consult your healthcare professional on

• If you are pregnant or planning for a pregnancy
• Medicines, supplements, and other drugs you might be undertaking.

Advised to avoid blood thinners including aspirin, ibuprofen, clopidogrel, warfarin, naproxen, and heparin.

After the procedure

You may experience fewer side effects after the procedure is performed such as discomfort in the area where the needle was inserted. Slight pain in the targeted area for approximately 2 to 3 days. However, the pain may rise after every passing day and significantly lasts for 2 to 3 days in some patients. If you’ve been administered anesthesia while performing the procedure you must ask someone to drive you home as your targeted areas will appear numb for a few hours.

Benefits vs Risks

Benefits

Epidural injections provide benefits on the basis of a person’s symptoms, disorders, and illness.

• Temporary or long-lasting pain relief
• Temporary or long-lasting reduction of inflammation in the spine
• Ability to perform daily activities without any pain or discomfort
• Reduction in other invasive procedures
• Feeling and significant improvement in pain 

Risks

There are several risks involved after getting epidural injection shots. The common risks involved are –

• Steroid Flush
• Sleeping problems
• Anxiety
• Headache (severe headache by spinal fluid leakage)
• Menstrual changes
• Bleeding of blood vessels
• Nerve damage
• Infection
• Paralysis
• Loss of feeling in legs for a few hours
• A temporary increase in pain
• High blood pressure (A patient with diabetes will experience high blood pressure)

Epidural steroid injections have several benefits and along with them, there are risks associated too such as the weakening of bones in the spine or nearby muscles for a duration. That’s why doctors usually administer these injections twice or thrice a year in a patient. Talk to your doctor about the risks and complications of the injections.