Epidural Steroid Injections

An epidural steroid injection is used to treat back and leg pain—especially pain caused by nerve irritation (William C. Shiel, 2008). These injections help pain by decreasing the inflammation and swelling around the nerve or base of the nerve (called the nerve root). This treatment of back or leg pain is not a cure, but helps to control the symptoms over a period of time. The goal is for the injection to help with pain so that the patient can participate in physical therapy, an exercise program or other therapy.

The procedure is often performed in an outpatient setting under CT guidance. This means that the doctor takes a picture of where the needle is going before medication is injected.

Where exactly does the needle go?

Sagittal View	Sagittal View
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The doctor inserts the needle through the skin so that the tip of the needle is in the epidural space—the area between the bony ring of the spine and the thick covering of the spinal cord (dura). The dura is the sac that surrounds the spinal cord and also contains spinal fluid and nerves. The epidural space contains fat and blood vessels. Medications that are injected into the epidural space, such as numbing-medications or steroid-type medications, bathe the spinal nerves and tissues. This decreases the inflammation and pain in the area.

Epidural steroid injections are done under CT guidance at KPMS. This means that the doctor will take a special type of x-ray to make sure the needle is in the correct place. The medication will then be injected into the epidural space.

Epidurals can last from a few weeks to a few months (William C. Shiel, 2008). Results vary among individuals and there is no way to know in advance who will be helped the most from the injections.

Complications are possible with any invasive medical procedure, but are rare with epidural steroid injections. Some complications that could occur include:

• Bleeding
• Infection
• Allergic reaction to the medication
• Pain at the injection site or worsening pain
• *Very rare—spinal cord damage or paralysis

Please talk to the doctor about any concerns or questions you have. Always notify your doctor if you are on a blood thinner before having a facet joint, or any type of spinal injection.

Bibliography

William C. Shiel, J. M. (2008, March 11). Medicine Net Procedures and Tests. Retrieved March 11, 2008, from Medicine Net: http://www.medicinenet.com/epidural_steroid_injection/article.htm