Epidural/Spine Injections
 
 

What is a Spinal Injection?

Your doctor may suggest that you have a spinal injection to help reduce pain and improve function.  This procedure can help relieve pain by reducing inflammation (swelling and irritation).  An injection can also help your doctor identify the source of your pain by numbing certain areas of your back.  The type of injection you receive is based on your specific symptoms and the physical examination performed by your health care provider.

Injections are used primarily after a specific diagnosis has been established.  Injections should be used in conjunction with an exercise program stressing muscle flexibililty, strengthening, and functional restoration.  A limited number of injections can be tried to reduce pain.

Preparing for Your Injection

A spinal injection is an outpatient procedure.  Before your injection, you will be asked questions about your health.  You will also be given instructions on how to prepare for the procedure.  You must be off any of the following:  NSAID's (anti inflammatories), ASA (asprin), Plavis, Coumadin (Warfarin), Lovenox, Heparin, Aggronox, Pletal, Gingko, Garlic, Ginseng for 5 days prior to your procedure.

Risks and Complications

All medical interventions have risks and benefits.  Spinal injections have certain risk and complications that include:

  • Spinal headache
  • Bleeding (rare)
  • Infection (rare)
  • Nerve injury (rare)

Certain procedures may carry other risks.  Your doctor will discuss these with you if it pertains to your situation.

During the Procedure

  • The procedure is usually brief, but your position during the procedure is important to make the injection go smoothly, with the least discomfort to you.  You may have monitoring devices attached to you during the procedure to check your heart rate and breathing.
  • Your skin will be cleaned with a sterilizing solution and a sterile drape will be placed over your skin.
  • Conscious sedation (use of a calming drug while you are awake) may be used if your doctor feels it is appropriate.
  • Local anesthetic (lidocaine) is usually given near the injection site to numb the skin.  This typically feels like a pin prick and some burning, like a bee sting.
  • Fluoroscopy (X-ray imaging) is often used for precise placement of the injection.  Contrast dye may be injected to confirm the correct placement of the needle.
  • A local anesthetic for numbing (e.g. lidocaine, bupivicaine) and/or steroids (to reduce inflammation) is injected.
  • A small bandage may be placed at the injection site.

After the Procedure

  • After some injections, you may spend time in a recovery area after the procedure.
  • You may be monitored to make sure you are doing well and your vital signs may be checked.
  • You may be asked to fill out paper work before leaving.
  • You usually should have someone drive you home.
  • You may put ice packs on the injection site for 10-20 minutes at a time if there is soreness.  Be careful not to burn your skin with the ice - place a towel between the ice and your skin.
  • You may take a shower but avoid baths, pools or whirlpools for 24-48 hours following the procedure.
  • You may be asked to relax on the day of injection, but usually can resume normal daily activities the day after the injection.
  • You usually can start or resume your individualized exercise program or physical therapy program within 1 week of your injection.

Side effects which may occur but go away in a few days may include:

  • Briefly increased pain
  • Headaches
  • Trouble sleeping
  • Facial flushing
  • Hiccups

It takes a few days, even a week or longer, for the steroid medicine to reduce inflammation and pain.  Your doctor may want to follow-up with you in 1-3 weeks.  If you had sedation, you probably should not drive for 24 hours after the procedure.

Greensboro Orthopaedics offers the following injections:

  • Epidural Corticosteriod Injections - effective in pain reduction in patients with radicular pain.  Most patients undergo a set number or "series" of injections.
  • Facet Injections - assist with pain reduction in order to facilitate an active physical therapy program.
  • Sacroiliac Joint Injection - used for both diagnostic and therapeutic purposes.  Injections can provide significant pain relief.
  • Discography - most often used prior to contemplating surgical fusion for unremitting pain due to a symptomatic internal disc disruption.
  • Diagnostic Selective Neural Blockade - used with patients with radicular symptoms.

 



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