Epidural Steroid Injection
An epidural steroid injection is a very common procedure with a long history of safety and success. The epidural space is a small space conveniently located next to the spinal fluid, the spinal cord, and the nerve roots. Steroid and local anesthetic medication, when injected into the epidural space, can help to calm inflamed nerve roots and other structures. When conservative therapy has failed, an epidural steroid injection can accelerate the healing process and facilitate a return to work or previous activities. In order to achieve maximum effect, often repeated injections are needed – typically three injections over 3 months.
Side effects of Epidural Steroid Injections are rare and your physician will discuss them with you. You will be asked to sign a written consent prior to the procedure. Please make sure you fully understand the risks and benefits of any procedure prior to signing the consent form.
Epidural steroid injections, as with most other procedures, are performed in our in-office fluoroscopy suite. X-ray or fluoroscopy is used for nearly all injections. Intravenous sedation is typically not offered but a mild oral sedative may be offered, depending on your medical condition.
You will not be able to drive following your procedure, so please make arrangements for transportation. You may resume normal activities the day after the procedure, unless otherwise directed by your physician. It may take a week or more for you to feel relief. Typically a follow-up evaluation is scheduled two weeks from the date of the procedure, so that you can discuss your response to the injection with your physician.
While some patients will require more advanced interventions, an epidural steroid injection is a very common, simple, and relatively safe procedure. Please contact our office if you have additional questions regarding this procedure.
Side effects of Epidural Steroid Injections
Side effects are rare, but fluid retention, insomnia, elevated blood sugar, bleeding, and infection have occurred. These side effects usually occur on patients taking strong anti-coagulants or blood thinners, or those with a high fever or an active infection. Diabetic patients will need to monitor their blood sugar before and after the procedure as steroid can cause blood sugar to rise. As long as a diabetic patient’s blood sugar is normal before the procedure and monitored after the procedure, the risk of a dangerously high blood sugar is low. Approximately 0.1% of patients experience a headache that is worse with standing. This “post-dural puncture headache” occurs when the protective membrane of the spinal canal is touched by the epidural needle during the procedure. If fluids and caffeine do not relieve this headache, an “epidural blood patch procedure” can be performed. A patient’s own blood is taken from their arm during the procedure and placed under sterile conditions into the epidural space to “patch” the small hole. The success rate for relieving a post-dural puncture headache with an epidural blood patch is almost 100%. Other less common risks include increased pain, kidney failure, bowel or bladder dysfunction, paralysis, and death. Your physician should be notified if you are taking medications such as Coumadin, Plavix, Ticlid, Lovenox, Aggrenox, Insulin, or Metformin. Your physician should also be made aware of any allergies you have, especially if you are allergic to iodine or contrast. Notify your physician immediately if you have concerns about your condition after the procedure.
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