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Epidural Steroid Injection

The epidural space is a space that exists in your spine within the spinal canal. This space sits between two planes of tissue: the sac of tissue that houses your spinal cord (dural sac) and the vertebral bones. The epidural space contains fat tissue along with blood vessels and nerve roots. Sometimes these nerves can be squeezed within the spinal canal, causing significant inflammation and pain.

Potential contributors to this include herniated discs into the epidural space, degeneration of the spinous structures such as the intervertebral disc and facet joints, or a narrowing of the spinal canal called spinal stenosis.

An epidural steroid injection can be used to diagnose and confirm the source of the pain as well as for therapeutic relief. Common conditions for which this procedure is used include disc herniations/radiculopathy, spinal stenosis, degenerative disc disease, post-herpetic neuralgia, post-laminectomy syndrome and vertebral compression fractures.

How It Works

Steroids can be injected into your epidural space via needle, with live x-ray guidance as necessary for accuracy and safety.

When this procedure is performed in the portion of the spine responsible for neck and arm pain, the procedure is called a cervical epidural steroid injection.

When it is performed in the portion of the spine that is causing mid-back, chest or abdominal wall pain, it is called a thoracic epidural steroid injection.

And when it is performed in the part of the spine causing lower back pain, the procedure is called a lumbar epidural steroid injection.

  • You will be asked to lie on your stomach.
  • The area of the injection will be cleaned with an antiseptic, and a sterile drape will be placed on it.
  • Your physician will inject a numbing medication (local anesthetic) to numb the skin.
  • Then, a needle will be guided into the targeted epidural space with X-ray guidance.
  • Contrast dye will be injected to confirm the proper spread of medications into your epidural space.
  • Steroids will then be administered into the epidural space through the needle. Steroids (cortisone) are potent anti-inflammatories which can provide substantial reduction of nerve pain.
  • Finally, the needle will be removed, and a sterile dressing will be applied.

Risks

Similar to any other procedure or medication, there are potential risks (although very low) of infection, bleeding, allergic reaction, spinal headache, nerve damage and prolonged increases in pain. Your JLR Center for Pain Medicine physicians will use x-ray guidance throughout the procedure as well as sterile techniques to significantly reduce these risks.