Epidural Steroid Injection
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1 Epidural Steroid Injection Selective Nerve Root Block An epidural steroid injection is done to: figure out the problem (diagnostic purpose) provide pain relief (therapeutic purpose) The injection provides pain relief by reducing swelling and irritation caused by a herniated disk, inflamed facet joints or narrowed spinal canal (stenosis). The injection usually contains a local anesthetic and a steroid. The anesthetic temporarily numbs the painful structure and the steroid reduces inflammation, which may provide longer term pain relief. The information in this handout is to help you prepare for your injection.
2 2 Epidural Steroid Injection (Selective Nerve Root Block) About the injection The injection can be done at different levels of the spine: cervical vertebrae neck thoracic vertebrae midback lumbar vertebrae lower back caudal (tailbone) Each of these areas may be treated using x-ray guidance. Cervical vertebrae Thoracic vertebrae Lumbar vertebrae Tailbone To provide pain relief a local anesthetic and steroid medication are injected into the epidural space surrounding the spinal cord and spinal nerve roots. Injections may be done between the vertebrae close to the midline through the tailbone or from the side along a specific spinal nerve. Spinal Process Spinal Cord Epidural Space Nerve Root Epidural Space
3 Epidural Steroid Injection (Selective Nerve Root Block) 3 Before your appointment If you are taking blood thinning and/or antiplatelet medications ask the doctor or nurse for instructions, at least 2 weeks before the procedure. If you are unwell, have a fever, an infection or are on antibiotics please call us at the Michael G. DeGroote Pain Clinic at , extension Please have a light meal and drink before your appointment. If you have diabetes, stick to your routine with what you eat and taking your regular medications. Please bring a list of your medications to every appointment. Come to the Pain Clinic 30 minutes before your scheduled appointment. An x-ray may be taken. Let us know if you could be pregnant. Let us know if you have an allergy to x-ray dye. Arrange to have a ride home. You may be in the Pain Clinic for about 60 to 90 minutes. Air travel: Notify your pain doctor or Pain Clinic staff if you are flying within 1 month after your injection. When you first arrive at your appointment You will be asked to change into a patient gown. You will need to complete a pain level questionnaire. Please review with the nurse about your problem, the medications you are taking and your activity level. You will have your blood pressure taken. You will sign your consent form. You may have an IV (intravenous) started. You will walk with a nurse into the procedure room. It is very important that you are aware and understand fully the risks and benefits of the procedure. Please discuss the risks and benefits of treatment with the doctor.
4 4 Epidural Steroid Injection (Selective Nerve Root Block) During the injection A nurse will be with you at all times and explain to you what is going on. You will first sit on the side of the bed and a blood pressure cuff is put on your arm. A probe is placed on your finger to check your heart rate and oxygen level. Your nurse will then help you move in the correct position for the injection. Lying Down Sitting 1. The doctor washes your back then injects the freezing medication. This makes the area numb. It may sting. 2. Then, the epidural space is located and the steroid medication is injected. The injection usually takes about 5 minutes, but may take longer. After the injection You will rest on a stretcher in the recovery area for about 15 minutes. A nurse will check you and your blood pressure.
5 Epidural Steroid Injection (Selective Nerve Root Block) 5 When you get home Rest. If you have a bandage take it off when you go to bed. Do not apply heat to the injection site. Do not soak in a tub bath, swimming pool or a hot tub for 24 hours after the injection. You can get back to your normal activities the next day, although there may be some pain at the injection site for several days. Side effects You may have some side effects after the injection. These include: headache - take pain medication as needed and drink lots of fluids. Drinks with caffeine may help. backache - apply ice to the injection site for 20 minutes every hour if needed. Wrap the ice pack in a plastic bag and a towel before you apply it. if you have diabetes you may notice an increase in blood sugar for 24 hours after the injection. Adjust your insulin and check your sugar levels as needed. Call your family doctor or diabetes specialist if you are unable to control your blood sugar. If you have any long term blood sugar changes, please let us know at your follow-up appointment. if you have high blood pressure, it may also temporarily increase.
6 6 Epidural Steroid Injection (Selective Nerve Root Block) Rare side effects Rare side effects that may happen with steroid injection include: a reduction of your body s ability to produce steroids. You may experience weakness, dizziness and fatigue. you may have too much steroid in your body, and may experience weight gain, skin changes, osteoporosis (bone thinning), and changes in sexual function. Please talk with your doctor if you have concerns or experience any of these side effects. Emergency Go to Emergency if you have progressive numbness and loss of sensation within 12 hours of your injection. Call us if you have: a severe headache that lasts for more than a few days a fever (temperature greater than 38 o C or o F) redness at the injection site severe back pain new numbness or severe weakness in the days after your injection Future surgery If you are having any type of surgery within 2 months of an epidural steroid injection, please tell your anesthesiologist and your pain doctor at the Pain Clinic.
7 Epidural Steroid Injection (Selective Nerve Root Block) 7 Notes: Michael G. DeGroote Pain Clinic McMaster University Medical Centre , extension or 42590
8 8 Epidural Steroid Injection (Selective Nerve Root Block) Hamilton Health Sciences, 2010 PD /2016 dpc/pted/epiduralsteroidinjecpainclinict-th.docx dt/april 25, 2016
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