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Epidural Steroid Injection

AMBULATORY CARE:

What you need to know about an epidural steroid injection (ESI):

An ESI is a procedure to inject steroid medicine into the epidural space. The epidural space is between your spinal cord and vertebrae. Steroids reduce inflammation and fluid buildup in your spine that may be causing pain. You may be given pain medicine along with the steroids.

How to prepare for an ESI:

Your healthcare provider will talk to you about how to prepare for your procedure. He or she will tell you what medicines to take or not take on the day of your procedure. You may need to stop taking blood thinners or other medicines several days before your procedure. You may need to adjust any diabetes medicine you take on the day of your procedure. Steroid medicine can increase your blood sugar level. Arrange for someone to drive you home when you are discharged.

What will happen during an ESI:

• You will be given medicine to numb the procedure area. You will be awake for the procedure, but you will not feel pain. You may also be given medicine to help you relax. Contrast liquid will be used to help your healthcare provider see the area better. Tell the healthcare provider if you have ever had an allergic reaction to contrast liquid.
• Your healthcare provider may place the needle into your neck area, middle of your back, or tailbone area. He may inject the medicine next to the nerves that are causing your pain. He may instead inject the medicine into a larger area of the epidural space. This helps the medicine spread to more nerves. Your healthcare provider will use a fluoroscope to help guide the needle to the right place. A fluoroscope is a type of x-ray. After the procedure, a bandage will be placed over the injection site to prevent infection.

What will happen after an ESI:

You will have a bandage over the injection site to prevent infection. Your healthcare provider will tell you when you can bathe and any activity guidelines. You will be able to go home.

Risks of an ESI:

You may have temporary or permanent nerve damage or paralysis. You may have bleeding or develop a serious infection, such as meningitis (swelling of the brain coverings). An abscess may also develop. An abscess is a pus-filled area under the skin. You may need surgery to fix the abscess. You may have a seizure, anxiety, or trouble sleeping. If you are a man, you may have temporary erectile dysfunction (not able to have an erection).

Call your local emergency number (911 in the US) if:

• You have a seizure.
• You have trouble moving your legs.

Seek care immediately if:

• Blood soaks through your bandage.
• You have a fever or chills, severe back pain, and the procedure area is sensitive to the touch.
• You cannot control when you urinate or have a bowel movement.

Call your doctor if:

• You have weakness or numbness in your legs.
• Your wound is red, swollen, or draining pus.
• You have nausea or are vomiting.
• Your face or neck is red and you feel warm.
• You have more pain than you had before the procedure.
• You have swelling in your hands or feet.
• You have questions or concerns about your condition or care.

Care for your wound as directed:

You may remove the bandage before you go to bed the day of your procedure. You may take a shower, but do not take a bath for at least 24 hours.

Self-care:

• Do not drive, use machines, or do strenuous activity for 24 hours after your procedure or as directed.
• Continue other treatments as directed. Steroid injections alone will not control your pain. The injections are meant to be used with other treatments, such as physical therapy.

Follow up with your doctor as directed:

Write down your questions so you remember to ask them during your visits.

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The above information is an educational aid only. It is not intended as medical advice for individual conditions or treatments. Talk to your doctor, nurse or pharmacist before following any medical regimen to see if it is safe and effective for you.

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