An epidural steroid injection is an injection of long lasting steroid in the epidural space - that is the area which surrounds the spinal cord and the nerves coming out of it. The steroid medication is injected into the epidural space.
What is the purpose of it?
The steroid injected reduces the inflammation and/or swelling of nerves in the epidural space. This may in turn reduce pain, tingling & numbness and other symptoms caused by nerve inflammation / irritation or swelling.
The actual injection takes only a few minutes.
This procedure is done under local anesthesia. It is done either with the patient sitting up or on the side, or on your stomach. The skin in the back is cleaned with antiseptic solution and then the injection is carried out. It may also be done under x-ray guidance.
Immediately after the injection, you may feel your legs slightly heavy and may be numb. Also, you may notice that your pain may be gone or quite less. This is due to the local anesthetic injected. This will last only for a few hours. Your pain will return and you may have a "sore back" for a day or two. This is due to the mechanical process of needle insertion as well as initial irritation form the steroid itself. You should start noticing pain relief starting the 3rd day or so.
We advise the patients to take it easy for a day or so after the procedure. Perform the activities as tolerated by you.
You should be able to unless the procedure was complicated. Usually you will feel some back pain or have a "sore back" only.
How long does the effect of the medication last?
The immediate effect is usually from the local anesthetic injected. This wears off in a few hours. The steroid starts working in about 3 to 5 days and its effect can last for several days to a few months.
It is very difficult to predict if the injection will indeed help you or not. Generally speaking, the patients who have pain "shooting" down the legs respond better to the injections than the patients who have only back pain. Similarly, the patients with a recent onset of pain may respond much better than the ones with a longstanding pain.
Generally speaking, this procedure is safe. However, with any procedure there are risks, side effects, and possibility of complications. The most common side effect is pain - which is temporary. The other risk involve spinal puncture with headaches, infection, bleeding inside the epidural space with nerve damage, worsening of symptoms etc. But these side effects are very uncommon. The other risks are related to the side effects of steroids. These include weight gain, increase in blood sugar (mainly in diabetics), water retention, suppression of body’s own natural production of steroids etc.
If you are allergic to any of the medications to be injected, if you are on a blood thinning medication (e.g. Warfarin, Plavix, Ticlid), or if you have an active infection going on, you should not have the injection.