One of the most commonly performed pain management procedures is the Epidural Steroid Injection or ESI, used to provide pain relief from spine-related conditions, such as pinched nerves or spinal stenosis. It is completely different from the kind of epidural given to treat labor pain for women during childbirth.
Labor and delivery epidurals are performed by an anesthesiologist in the hospital and create numbness and weakness below the waist. No steroid is used, but a strong anesthetic medication is delivered through a catheter, providing pain relief and total lack of feeling. A woman having an L & D epidural will not be able to walk until the numbing medication wears off.
The type of epidural injection used to treat spinal and limb pain is different in several ways. It is performed in a doctor’s office in a procedure room, using special X-ray equipment called a C-Arm. A type of X-ray guidance called fluoroscopy is used, which gives the doctor a real time image of the spine.
The doctor injects anti-inflammatory steroid medication, not numbing medication, and the patient does not have weakness or lack of feeling as a result. To determine the best location for medication to be placed, during your ESI you should be asked about your symptoms, get a physical exam and compare the location of your pain to the MRI or CT scan ordered for you. A small injection of numbing medication is given where the epidural is to be inserted. The needle is placed correctly and a small amount of contrast dye is injected. This dye confirms the optimal placement for the injection. The steroid is injected and the needle is removed. This type of epidural does not produce significant numbness or weakness and the patient can walk immediately after the procedure.
There may be some soreness or bruising at the injection site but the application of ice helps. Patients can also take Tylenol for discomfort. After the epidural steroid injection, you must have someone drive you home because the injection may cause dizziness, which will pass after a few hours. It is recommended that you avoid taking a bath for 24 hours after the injection, but you can shower any time.
All epidural steroid injections carry a small risk for complications, such as infection at the injection site, a puncture of the dura, post-injection headache or an allergic reaction to the contrast dye used. All of these, should they happen, are easily treatable, do not cause paralysis and are not life-threatening if treated.
Pain relief is usually not immediately felt from the steroid, but from the numbing medication that is combined with the steroid. This pain relief is temporary and passes in a few hours. Steroids generate a reduction in inflammation, usually resulting in a decrease in pain. This effect will typically be seen within 3 to 5 days.
Often times, patients report being very nervous about having an ESI. Many incorrectly equate it with the kind of epidural given in Labor & Delivery. Some think that the shot could potentially paralyze them or that some other horrific side effect will happen afterwards. Epidural Steroid Injections are very safe and effective when given by a trained pain management specialist.
For more information epidural injections for pain, contact Comprehensive Pain Management in Franklin, MA.
Source: Daily Press