The Pain Treatment team has suggested an epidural block (also called an epidural steroid injection) to treat your pain. This treatment can be performed in the cervical ,thoracic and lumbar area. If it is in the cervical or thoracic area an intravenous will be placed for access. You will need to stop all blood thinning medicines prior to the procedure to avoid increased risk of bleeding. Our protocol is 10 days for aspirin and plavix, 3 to 5 days NSAIDS (motrin, aleve, advil, feldene, mobic, and others), coumadin 7 to 10 days with blood levels checked prior to procedure. If you choose not to follow these guidlines you risk to be cancelled for your procedure .
This procedure will be completed at the Pain Treatment Center using flouro guidance (low-dose X-ray). This procedure is usually completed in a series of three treatments 2 to 3 weeks apart.
An epidural steroid injection is indicated for such conditions as spinal stenosis, herniated disc, or degenerative disc disease.
The nurse will perform a short assessment and provide you with suitable attire. You will lie on your stomach for approximately 10-20 minutes the radiological technologist, nurse, and physician will be present during the entire procedure.
The physician will instill a local anesthetic. When the area is numb a needle will be positioned at the appropriate location. Through this needle a long acting anti-inflammatory (steroid) called Kenalog will be placed. Usually the procedure is performed with local anesthesia in that case you can drive home after the procedure. If sedation is used you must fast 8 hours prior to procedure and must have a ride home. You will be required to maintain light activities for 48 hours. After this time period you may increase your activities slowly. You may notice immediate relief but it may not be noted for a week following the procedure.
Pain may be exacerbated (worsened) for the first 48 hours. This procedure is very safe and complications are very rare but include skin infection, bruising, hematoma , spinal headache . These side effects can all be treated by the physician if necessary.
Aspirin and other blood-thinning medication must be stopped prior to this procedure (includes most anti-inflammatory medication).
To view a color brochure of the instructions for this procedure, click here.