What is the Epidural Space?
The membrane that covers the spinal cord and nerve roots in the spine is called the dura membrane. The space surrounding the dura is the epidural space. Nerves travel through the epidural space to the back and into the legs. Inflammation of these nerve roots may cause pain in these regions due to irritation from a damaged disc or from contact in some way with the bony structure of the spine.
What is an Epidural and Why is it Helpful?
An epidural injection places anti-inflammatory medicine into the epidural space to decrease inflammation of the nerve roots, hopefully reducing the pain in the back or legs. The epidural injection may help the injury to heal by reducing inflammation. It may provide permanent relief or provide a period of pain relief for several months while the injury/cause of pain is healing.
What Happens During the Procedure?
An IV is started so that relaxation medication can be given. The patient is placed lying on their side on the table and positioned in such a way that the physician can best visualize the low back. The skin on the back is scrubbed using sterile scrub (soap). Next, the physician numbs a small area of skin on the low back with numbing medicine. This medicine stings for several seconds. After the numbing medicine has been given time to be effective, the physician directs a small needle into epidural space. A mixture of numbing medicine (anesthetic) and anti-inflammatory (cortisone/steroid) is injected.
What Happens After the Procedure?
Patients are then returned to the recovery area where they are monitored for 30-60 minutes. The legs may feel weak or numb for a few hours. This is to be expected, however it does not usually happen.
General Pre/Post Instructions
Patients can eat a light meal up to 6 hours before the procedure. Patients may take their routine medications. (i.e. high blood pressure and diabetic medications). Patients should not take anti-inflammatory medications the day of their procedure (i.e. Voltarol, Aspirin, Ibuprofen). These medicines can be restarted after the procedure if they are needed. Patients are seen for follow up in the outpatient clinic six weeks after the injection.