Epidural Steroid Injection
An epidural injection is an injection of steroid and occasionally some other medications into the epidural space.
The long acting steroid injected reduces the inflammation and swelling of spinal nerves and other surrounding tissues in the epidural space. This may in turn reduce symptoms of sciatica including pain, tingling, and numbness.
You should be able to go back to work the next day unless the procedure was complicated. Usually you will feel some soreness or aching at the injection site only. Depending on the amount of inflammation, an injection can offer several months of pain relief. For some people, one injection can provide long-term pain relief. Depending on your response to the first injection, your doctor will determine if additional injections are necessary.
The actual injection takes 5 to 10 minutes. A local anesthetic will be used to numb the skin. The doctor will then insert a needle directly into the epidural space. If at any point in time the procedure becomes painful, you should let the doctor know as he can use more anesthetic to numb the painful area. Fluoroscopy, a type of x-ray, will be used to ensure the safe and proper position of the needle. A dye will also be injected to make sure the medicine will go into the correct spot. Once the needle is in the correct location, an anesthetic and a steroid will be injected.
In general IV sedation is not necessary for the injection and is well tolerated without the need for sedation. In some cases light conscious sedation can be used to ease the anxiety and pain associated with the procedure.
Generally speaking, epidural injections are is safe. However, with any procedure there are risks, side effects and possibility of complications. The most common and usually temporary side effects are bruising, soreness or other pain at the injection site. Uncommon risks involve spinal puncture with headaches, infection, bleeding inside the epidural space, nerve damage or worsening of symptoms. Other risks are related to the side effects of the long acting steroid such as weight gain, increase in blood sugar in diabetics, water retention or suppression of body's own natural production of steroids.