What is an Epidural?
You may have heard of the epidural injections, the pain-relieving shots given to pregnant women during childbirth. The medical name for these injections is epidural steroid injection (ESI). But doctors also use it for other purposes.
The doctor administers the injection in your epidural space, resting outside the membrane that protects your spinal cord. Usually, doctors use it to relieve pain during and after any type of surgery. They also use epidural injection to help patients manage chronic pain. It aids in relieving arm, neck, back, and leg pain that occurs due to inflamed spinal nerves because of disc herniation or spinal stenosis.
This procedure is not beneficial for every patient. But if your health professional recommends you, it will require a lower dose of medicine, leading to fewer side effects. Epidurals help you get long-lasting relief from pain and stay alert and mobile.
Conditions that May Require Epidural Steroid Injections (ESI)
The following are some conditions where doctors may use epidural shots to ease your pain.
Spinal Stenosis
It is the narrowing of the nerve root canal and spinal canal, which can cause leg and back pain, especially when you are walking.
Spondylolisthesis
It is a fracture or weakness between the lower and upper facets of a vertebra. When a vertebra slips forward, it causes pain by compressing the nerve roots.
Herniated Disc
The gel-like material present in the disc can burst or bulge through a weak area in the annulus. Pain, swelling, and irritation can occur when the material comes out and contacts your spinal nerve.
Degenerative Disc
It occurs when the intervertebral disc gets thinner, and the disc space begins to collapse. It also leads to abnormal bone growth and causes tears in the annulus.
Sciatica
This pain occurs because of the compression of the 1st sacral or the 5th lumbar spinal nerve.
The procedure of getting an epidural injection can take 15 minutes, and the numbing effect starts to work quickly after shot. The pain relief duration can vary from person to person. This injection doesn’t always give you relief for a lifetime, but it can relieve the symptoms causing the pain for a few months.
Doctors also use these injections to find the source of your pain. For this reason, they inject the solution into a specific nerve in your body. If you feel relief after that, your doctor will know that this nerve is the source of pain.
The most common side effect is you may feel more pain until the injection starts to work. Other side effects of epidural shots can be bleeding, infection, temporary numbness or weakness, nerve damage, or headache.
Epidural Steroid Injections Procedure
The doctor may ask the patients to change their clothes to examine and locate the nerve easily and get access to do the procedure. An epidural steroid injection takes 15 to 30 minutes and goes through some standard protocols. Here are the steps of the procedure, which usually every doctor follows.
- You need to lie flat on the X-ray table and can put a small pillow under the stomach. If you feel uncomfortable with this position, you can sit or lie on the other side in a curled position.
- The doctor will clean the skin from the low back area and numb with local anesthesia, similar to the one dentists use.
- Doctors use fluoroscopy (live X-ray) for guidance. They insert a needle and direct it towards the epidural space. Fluoroscopy is important to administer the shot in the epidural space. Some studies have found that the doctors may inject the solution in the wrong nerve if they do not use fluoroscopy.
- Once the doctor gets the needle in the proper position, he will inject contrast to determine the needle location. After the confirmation, he will inject the epidural steroid solution. Although doctors administer the solution slowly, some patients feel pressure due to the amount of medication used. However, the pressure of the injection is not usually painful.
- After the procedure, the doctor will monitor your condition for around 15 to 20 minutes before discharging you.
- You may feel tenderness at the needle insertion’s area for a few hours after the procedure. However, you can simply treat it by applying an ice pack for 10 to 15 minutes once or twice an hour.
- Not to mention, your health professional may ask you to rest for the remaining day. You also have to avoid regular activities and resume from the next day of getting the injection. Patients sometimes feel more pain for several days after the process due to the local chemical irritation or fluid pressure.
- Moreover, it is important to discuss with your doctor before getting this injection. It will help you to understand the protocols. Also, you need to understand what precautions you need to take.
Bottom Line
Epidural injections are common and very helpful for chronic pain. They often have fewer side effects than other treatment types. If you’re looking for a specialist to treat your pain, Dr. Matthew Grimm can help you. Call us at 646-862-5555 or visit our website for further details to book an appointment with our pain management specialist today.
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