At Vidyasagar Hospital we treat all types of pain, including musculoskeletal, spinal and neuropathic pain disorders. With an accurate diagnosis and early intervention, we hope to help patients avoid spiraling into a state of chronic pain, or at least reduce the severity of pain, and improve patients’ quality of life. Minimally invasive procedures and proper use of medications are implemented to achieve those goals.
Lumbar Epidural Steroid Injection
An epidural steroid injection (ESI) is an injection of a small dose of anti-infl ammatory medication (called a glucocorticoid) into the lower back to relieve pain in your legs or lower back. The medication is injected into an area of fatty tissue surrounding the spinal nerves called the epidural space. By reducing infl ammation, an ESI can help reduce your pain. An ESI can be both a treatment and a way to diagnose a specifi c nerve root problem when there is a question.
Steroids are a general name for glucocorticoids. The steroid injected is a man-made, synthetic drug that is similar to cortisol, a natural hormone produced in the adrenal gland and brain. Steroids help to reduce pain and inflammation and are used to treat a variety of inflammatory diseases and painful conditions, including lumbar disc herniation.
You will meet with a doctor who will review the risks and benefi ts of the procedure and answer any questions you may have. The potential side effects of an ESI include, but are not limited to:
- Spinal headache
- Temporary leg weakness or numbness
Two weeks before the procedure:
- Let us know if you have bleeding disorders, or if you are using blood thinners like aspirin, Coumadin® (warfarin), Plavix® (clopidogrel), Ticlid® (ticlopidine), heparin, Lovenox® (enoxaparin), Fragmin® (dalteparin), Aggrenox® (dipyridamole), or NSAIDS (such as ibuprofen, naproxen, nabumetone, diclofenac, etodolac, indomethacin, ketorolac, meloxicam, piroxicam, ketoprofen, oxaprozin), or especially any herbal bloodthinning medications. The above listed medications may increase risk of bleeding complications.
- If you are taking a blood thinner, please call your primary care physician or cardiologist and ask if it is safe to stop the medication. You will be instructed on how to stop it when it is time for your injection. This will decrease the likelihood of bleeding complications.
- Please honestly review all your medications with us prior to the ESI procedure. Please inform our staff about any medication changes.
- Please let us know if you have had fevers, antibiotic treatment, any illnesses, or hospitalization within the last 4 weeks. You must be healthy on the day of the procedure.
- You will be fully awake during the procedure. Sedation is occasionally used. Discuss with your physician or staff when scheduling the procedure.
- If you have diabetes, your blood sugar numbers may increase. Your primary care physician or our staff will counsel you regarding management. Bring your diabetes medication with you so you can take it after the procedure.
- Continue to take all medications, ESPECIALLY BLOOD PRESSURE MEDICATIONS. Bring all your medications with you so you can take them as needed after the procedure. Please note: your blood sugar and blood pressure will need to be within a safe range on the day of the procedure.
- Pain relief may begin immediately after the medication has been injected. You may experience a brief recurrence of your former pain until the anti-infl ammatory medication takes effect. Apply ice to the injection site to decrease discomfort.
- A bandage may be placed over the injection site.
- You will rest, lying down, in a recovery room for 15 to 30 minutes.
- A nurse will check your blood pressure and pulse. The nurse will also discuss your discharge instructions with you.
- A responsible adult must drive you home. You must not drive yourself.
- Some people may experience numbness or an inability to walk for a short time after the procedure. If this occurs after your procedure, a wheelchair can be provided to assist you to the car.