Epidural Injection
Piedmont offers a variety of non-surgical options for back pain relief, including epidural steroid injections in which medication is injected directly into the epidural space.
Depending on the pain generator, a patient may have a lumbar epidural injection (the needle is inserted between the vertebral bones of the lower spine), a transforaminal injection (the needle is inserted into the place where the nerve root exits), or a caudal epidural injection (the needle is inserted near the tip of the sacrum).Piedmont surgeons use advanced imaging to place the needle in just the right spot before injection a solution of anesthetic and a corticosteroid.
The epidural injection decreases pain and increases the speed of recovery of an injured nerve or disc by reducing inflammation. Patients at Piedmont typically begin experiencing relief in as little as two days. This relief can last months, and even years for some patients. The experience varies depending on the patient and the extent of the injury to the nerve or disc, and some patients may not see relief for several days, and some cases may require more than one injection.
Transforaminal Injection
A transforaminal epidural injection is unique in that your surgeon can deliver medication to a precise nerve root. Piedmont physicians employ transforaminal injections as both a tool for pain relief and diagnostics. If a patient experiences immediate relief when a numbing medication (lidocaine) is injected into the nerve root in question, the physician has identified the correct source of the pain. This allows you and your surgeon to focus efforts on the correct nerves and target the actual source of the pain with a longer lasting corticosteroid.
This outpatient procedure is an injection of a steroid-anesthetic medication through an opening in the sacrum. The medication can reduce swelling and inflammation of irritated spinal nerves. The injection takes only a few minutes to complete.
Although each patient experience is unique, here is a general outline of what to expect with your epidural steroid injection:
Preparation
In preparation for the procedure, the patient lies face down. A cushion is placed under the abdomen to elevate the sacrum.
Anesthetic Injected
The physician administers a local anesthetic to numb the skin and the tissue above the small opening at the base of the sacrum. This opening is called the sacral hiatus.
Needle Inserted
When the area is numb, the physician guides a needle through the sacral hiatus and into the caudal epidural space. This is the open space in the sacrum where the irritated nerve roots are located.
Contrast Solution Injected
The physician injects contrast solution through the needle. The physician uses a fluoroscope (a type of x-ray device) to confirm that the tip of the needle is positioned correctly within the epidural space.
Medication Injected
After the needle's position has been confirmed, the physician injects a steroid-anesthetic medication. This medication bathes the irritated nerve roots. It will help alleviate the patient's pain.
End of Procedure
When the procedure is complete, the physician removes the needle and bandages the insertion site. The patient may feel significant relief after one injection. Some patients may need multiple injections before they feel the full benefit of the medication.
© 2007 Swarm Interactive
Learn More About Non-surgical pain relief options
If you would like to learn more about epidural steroid injections and other non-surgical options for pain relief, schedule a consult with our spine team. Click here or give us a call to get started.
Lumbar Epidural Injection
Overview
This injection procedure is performed to relieve low back and radiating leg pain. Steroid medication can reduce the swelling and inflammation caused by spinal conditions.
Patient Positioning
The patient lies face down. A cushion under the stomach area provides comfort and flexes the back. In this position, the spine opens and allows for easier access to the epidural space.
Tissue Anesthetized
A local anesthetic is used to numb the skin. All the tissue down to the surface of the lamina portion of the lumbar vertebra bone is anesthetized. The physician slides a thicker needle through the anesthetized track.
Fluoroscopic Guidance
Using a fluoroscope for guidance, the physician slides the needle toward the epidural space between the L-4 and L-5 vertebra. A contrast solution is injected. The physician uses the fluoroscope to confirm the correct location of the needle tip.
Steroids Injected
A steroid-anesthetics mix is injected into the epidural space, bathing the painful nerve root with soothing medication.
End of Procedure
The needle is removed, and a small bandage is applied to cover the tiny needle surface wound. In some cases it may be necessary to repeat the procedure as many as three times to get the full benefit of the medication. Many patients get significant relief from only one or two injections.
© 2013 Swarm Interactive
Learn More About Non-surgical pain relief options
If you would like to learn more about epidural steroid injections and other non-surgical options for pain relief, schedule a consult with our spine team. Click here or give us a call to get started.