Board Certified, New York City Based, Osteopath Specializing in Spine, Pain and Sports Medicine
What Is An Epidural Injection?
The epidural area surrounds the spinal cord and the nerves coming out of it. The space is an area located outside the sac of the (membrane) spinal cord. Epidural steroid injections (ESI) refer to a procedure in which a small amount of steroid and local anesthetic is injected into the epidural space. Sometimes these injections are just called “epidural” for short. It can be performed for neck, arm, chest, low back, leg pain, and pain following a case of shingles. The injection helps reduce inflammation due to the steroids being placed directly on inflamed tissues and nerves. The epidural reduces inflammation, pain, tingling, and numbness around the nerves in the epidural area. The pain relief achieved with an epidural injection can eliminate the need for oral medication or even surgery. If you are getting relief from these injections, these may be repeated in a series of 2 to 3 injections.
How Is An Epidural Injection Different From A Nerve Block Injection?
A nerve block injection numbs the area surrounding the nerve causing pain, usually with an anesthetic like Lidocaine. Nerve block injections help doctors diagnose the issue causing the back pain. It is also sometimes administered as an anesthetic for surgery or other medical procedures. Epidural steroid injections may also provide blockage of neighboring nerves exiting the epidural space, but the target is the region of inflammation within the epidural space.
What Happens When The Epidural Is Injected?
The procedure is performed in a surgical facility using a live X-ray called a fluoroscope. An IV may be placed in your arm if you have opted for sedation for the procedure. You will be lying face down and the area to be injected will be sterilized and numbed with a local anesthetic. X-ray will be used to place the needle at the site and inject the medication. The needle may not necessarily be placed in exactly the same site as your pain. The medicine will “float” to coat nearby nerves. You may feel some pressure in your back/neck or some re-creation of your pain symptoms. After the injection your pain level can be decreased tremendously because of the local anesthetic. This will wear off in a few hours and there may be a return of your previous pain. You should see improvement in 3-14 days from the effect of the steroid. Your vital signs will be monitored briefly, and you will be discharged to go home. The whole process takes about 20-30 minutes
Epidural Injection Follow Up
Discomfort is minimal and most patients are able to stand and walk around immediately after the procedure. Patients are monitored for a short period after the procedure before going home. Post-procedural soreness is best addressed by icing the region for 15-20 minutes 3-4 times a day as needed. Any immediate relief may be from the local anesthetic used. Sometimes the anesthetic may wear off before the steroid starts working and pain may return to pre-injection levels. The steroid may take from 1-14 days to start working so to properly assess your response, a follow up visit in 1-2 weeks after the procedure should be scheduled.
Cost of Epidural Injection
Depending on insurance coverage this may be covered by your plan. We are committed to providing extraordinary care that is still affordable. Payments from most insurance plans are accepted as a non-par provider (i.e. we accept out of network benefits). If health insurance coverage is not accepted or with high deductible plans, alternative payment arrangements can be made depending on the specific circumstances.