An epidural block is performed under fluoroscopy to confirm a specific diagnosis and/or decrease pain and inflammation. This can be given in the cervical (neck), thoracic (upper back), and lumbar (lower back) area. The epidural space is a sponge-like cushion that surrounds the spinal cord within the spinal canal.
Lower back pain, leg pain and arm pain are usually caused from inflammation and irritation of nerve roots. This may be due to arthritis, ruptured or bulging disc and continued post-operative scarred or swollen tissue. By injecting a steroid into the epidural space that surrounds the nerve roots, maximum relief is achieved.
Frequently Asked Questions About Epidural Block
Who will give me the epidural and how is it done?
Epidurals are administered by a pain medicine specialist trained in chronic pain therapy. A local skin anesthetic is given. An epidural needle is then gently inserted into the epidural space of the cervical, thoracic, or lumbar area, depending on the area of your pain. A combination of local anesthetic (numbing medicine) and steroid (anti-inflammatory medicine) are injected into the epidural space.
How long does this procedure take?
It will take less than an hour for actual procedure.
Why can’t I just take oral steroids?
When steroids are taken by mouth most of the medication is absorbed in the stomach and distributed equally throughout the entire body. Very little reaches the true source of the pain. The steroids reduce swelling and irritation which will reduce the pain.
What should I expect?
You will be taken to a procedure room and positioned lying on your stomach. The area will be cleansed with a sterile solution and numbed with an injection of Lidocaine. Many describe a burning or stinging sensation for a few seconds. After that you should just feel pressure. The physician will continuously communicate with you what to expect during the process.
Will it work immediately?
Most will experience some immediate relief from pain due to the numbing medication that is mixed with the steroid. This will last from one to three hours and the pain will return. It will take about three days for the steroids to start working on the nerve root.
How should I prepare for the injection?
You may eat lightly before the procedure; ARRANGE FOR A DRIVER TO TAKE YOU HOME. Your procedure will be rescheduled if you do not have a driver; Notify the nurse if you are taking blood thinner, Aspirin or an anti-inflammatory. Approval will be needed from the doctor who ordered the blood thinner to stop taking the medication four days in advance for Coumadin, seven days for Aspirin and four days for anti-inflammatories and Plavix. Blood will need to be drawn prior to procedure to make sure it is not too thin; You may take your routine medication the day of the procedure (heart, diabetes, blood pressure); Expect to be at the office one to three hours. This includes registration, paperwork, review of consent, procedure, recovery and review of discharge instructions.
For what reason should I call the Pain Center after the injection?
If you experience severe back pain, new numbness or weakness of your legs, or signs of infection in the area of the injection, you should call The Pain Center immediately at (870)972-0411 or go to the nearest emergency room. Our office hours are 7:45 a.m. to 4:45 p.m. Monday through Thursday and 7:45 a.m. to 12:00 p.m. on Friday.