Epidural Steroid Injections
Patients who experience lower extremity pain may benefit from a caudal steroid injection. Specific spinal conditions, such as spinal stenosis, radiculopathy, sciatica, and herniated discs can cause the lower extremities to become inflamed or cause pain.
Caudal epidural steroid injections may be performed at a number of surgery center locations. Prior to the surgery center visit, the patient will be instructed to abide by the “Pre-Procedure Instructions.” These instructions can be found in the “Injections” tab.
After the patient has changed into a gown and been prepped for the procedure by the nurses, the patient will be taken to the operating room. If elected, anesthesia will be administered by a licensed professional. A local anesthetic is then used to numb the tissue and skin surrounding the exterior of the sacral hiatus. Using fluoroscopy, the physician localizes a tiny slit or opening at the foundation of the sacral hiatus. Following the path where anesthetic was inserted, the physician carefully slides the needle in one to two centimeters deep. At this point a non-allergenic iodine (“contrast”) is placed inside the sacral hiatus space, which illuminates the diseased and/or tender areas. The indicated areas help the physician know where to inject the therapeutic combination of steroid and anesthetic. Once the area is infused with the medication, the physician removes the needle and places a bandage over the small needle hole. Some patients require multiple injections before they feel substantial relief of pain. Injection treatment plans are determined on an individual basis, as all patient circumstances differ.
Pinched nerves located within the cervical spine can cause intense pain and inflammation throughout a patient’s neck, shoulders as well as arms. When a nerve is pinched, it will swell up which is the pain source of pain. In order to diminish the swelling, a medicated injection is used to calm the nerves. Patients who suffer from herniated discs, spinal stenosis or radiculopathy can also benefit from this injection as well.
For the comfort of the patient, he or she will be lying face down during the entirety of the treatment. Depending on the patient or circumstances, an intravenous sedation may or may not be needed. The cervical epidural steroid injection requires the patient to receive local anesthetic to numb the neck’s skin and tissue with a small needle. A Fluoroscopic procedure is performed by the physician to help navigate the needle inside the epidural space where the spinal nerves travel. In order to double check the correct position of the needle, a colored dye is inserted. It is imperative for the needle to be beside the aggravated nerves strictly for full absorption of anesthetic and cortisone mixture. This steroid mixture will lessen the stress and engorgement of the affected nerves. The procedure is completed and a bandage applied to the injection spot. Since anesthesia is used, relocation of the recovery room until the patient wakes up. The patient is allowed to eat and drink once fully alert. When the physician clears the patient to go home, proper instructions are given to avoid complications or infections. Depending on the severity of the pain, a patient may or may not need another injection. If another injection is required, the patient must wait a full two weeks before receiving another treatment.
A lumbar epidural steroid injection provides relief for patients with symptoms such as swelling, inflammation, lower back pain, and radiating pain caused from spinal conditions. As the patient lays face down with a small pillow under the stomach for comfort as the back flexed back. This allows the spinal area to be open for easier access as the physician located the epidural space. A fluoroscopic used to help locate the correct lumbar vertebra as well as the nerve root. Once this is completed, a local anesthetic numbs the entire length of tissue to the surface of the lamina portion of the lumbar vertebra. A thicker needle slides down the anesthetized track guided by a fluoroscope towards the epidural space between the L-4 and L-5 vertebra.
An injection of contrast solution and the fluoroscope helps the physician locate the painful areas. While locating the painful area, the physician then injects a combination of steroid-anesthetics into the epidural space. This will then soothe the nerve root relieving some pain. Many patients receive a significant amount of relief from one or two injections while a third may be required. A small bandage is placed over the surface where the needle is taken out.