Cervical Thoracic & Lumbar Epidural Injections

What is an epidural spinal injection and how does it work?

Using an epidural spinal injection, doctors at the Florida Hospital Celebration Health Spine Center are able to deliver an anti-inflammatory medication directly into the area where the spinal nerves are causing the pain.  Known as the epidural space, this area surrounds the sheath-like membrane, or dura, that covers the spine nerves and nerve roots.

Typically, the medication is a steroid combined with an anesthetic. The steroids reduce the irritation in the nerves by inhibiting production of the proteins that cause inflammation. The anesthetic blocks the area where it’s applied, reducing the sensation of pain.

What is an epidural spinal injection used for?

Spine, back, and pain experts at the Florida Hospital Celebration Health Spine Center use epidural spinal injections for diagnostic and therapeutic reasons.

• Diagnostic: Physicians can use the epidural spinal injection in a specific nerve root to determine if it is the cause of the pain. This helps isolate the area so additional pain management strategies can be used on the targeted area.
• Therapeutic:  When used therapeutically, a spinal epidural injection can provide short-term and long-term relief, ranging anywhere from a week to several months. In some cases, it can even provide permanent relief, because it breaks the endless cycles of inflammation.

An epidural spinal injection won’t permanently eliminate the symptoms associated with spinal compression. Instead, doctors at the Florida Hospital Celebration Health Spine Center will use it as a treatment tool to help ease your pain and reduce the discomfort you’re experiencing, while they address the root causes with rehabilitation, nonsurgical treatment strategies, or surgery.

How is the epidural spinal injection administered?

Performed at the Florida Hospital Celebration Health Pain Medicine Center, doctors use the following procedure to administer an epidural spinal injection:

• A mild sedative will be delivered by an IV drip, if you wish, to help you relax.
• The physician will then position you so that there is clear access to the spine area. Depending on the actual location, you may be asked to lie facedown, on your side, or sit upright in a chair.
• Your skin will be cleaned with an antiseptic in the area where the needle will be inserted.
• Before the epidural spinal injection, you’ll receive a local anesthetic to numb the area.
• A small needle will then be inserted. Your doctor will use a fluoroscopy, a type of X-ray, to guide the needle into the exact place it needs to be. Once there, a small amount of contrast dye will be injected to confirm proper placement
• Finally, the steroid/anesthetic medication will be injected into the epidural space.
• Once completed, your doctor will remove the needle, clean the injection site with an antiseptic, and cover it with a bandage.

The entire procedure takes between 15 and 30 minutes. Afterwards, you’ll be monitored in the recovery room for up to an hour. You should not drive for the rest of the day and avoid strenuous activity. Your physician will explain all this to you and provide comprehensive after-care instructions.

How will I feel afterwards?

After the epidural spinal injection, you may experience some numbness in your legs or arms. This is temporary and should go away in 1-8 hours. In the first day or two, the pain may actually increase a bit. This is normal; it generally takes 24-72 hours for the epidural spinal injection to fully take effect.

How often can I get an epidural steroid injection?

If your injection does resolve your pain issue for a short period of time, you may want another injection. For your safety, most physicians limit the number of injections to three per year.

Are there any complications or risks?

As with any procedure, there can be complications. Though not common, side effects may include:

• Localized bleeding or infection at the site of the injection
• Pain during and/or after the injection
• Possible headache following the injection
• Negative reaction to the medication
• Nerve injury, including injury to the spinal cord and quadriplegia
• Bladder dysfunction
• Fluid retention
• Respiratory arrest
• Epidural hematoma (where blood collects outside the blood vessel because of a leak or injury)
• Spinal cord infarction (which occurs when one of the three major arteries that supply blood to the spinal cord is blocked)

In some cases, particularly when the injection would need to be performed in the cervical spine rather than the lumbar (low back) portion of the spine, your physician may recommend the use of oral steroids in place of a cervical epidural spinal injection.

Risk factors to consider before you agree to an epidural spinal injection include:

• If you take platelet-inhibiting drugs such as aspirin or NSAIDS, you may be at risk of increased bleeding.
• If you are suffering from an infection, steroids can reduce your body’s resistance and your ability to fight the infection.
• If you have hypersensitivity or are allergic to certain medications, you may have a negative reaction to the drugs used in an epidural spinal injection. Be sure to discuss all the medications you are on as well as any known allergies with your doctor.
• If you have a chronic medical issue, such as diabetes, congestive heart failure, renal failure, hypertension, or a significant cardiac disease, you will want to discuss how these conditions can affect your injection.
• If you are pregnant, a fluoroscopy can pose a risk to the development of the fetus.

As a leader in back and neck pain, the Florida Hospital Celebration Health Spine Center has the experience and expertise to ensure that your treatment regimen addresses your pain management needs. As always, your doctor will discuss all the options with you so that you can make the most informed choice about your treatment.