Smuck M, McGehee M, Farhat R, Ali A. Single Insertion for Multiple Injections: a Safer and Less Painful Technique for Concomitant Facet Joint and Transforaminal Epidural Injections. American Academy of Physical Medicine and Rehabilitation 68th Annual Assembly and Technical Exhibition Poster Presentation. Boston, MA, September, 2007.
- During the procedure, the patient lies down with a cushion underneath their stomach to increase flexion in the lumbar spine, giving more room for the needle to pass through.
First, a local anesthetic is used to numb the skin above the injection site. Using X-rays, the needle is guided into the epidural space.
Contrast dye is injected to confirm the proper placement of the needle in the epidural space.
The injection itself may include local anesthetic and/or saline along with the steroid medication to give immediate pain relief and flush the area of inflammatory agents.
The mixture is injected and the steroid acts to reduce the inflammation around the spinal nerve roots.
The needle is removed and a small bandage is placed on the injection site. The patient is monitored for a short time before being discharged home.
- Patients may be asked to change into a hospital gown, which allows for access to clean the injection area and to allow the physician to easily visualize the injection site. An epidural steroid injection usually takes between 15 and 30 minutes and follows a relatively standard protocol:.
- Sedation is available for patient anxiety and comfort. However, sedatives are rarely necessary, as the epidural steroid injection procedure is usually not uncomfortable. If a sedative is used, some patient precautions should be taken, including not eating or drinking for several hours prior to the procedure and having a guardian available for discharge. A patient should contact his or her doctor for specific instructions.