How to Decrease Back Pain with an Epidural Steroid Injection

Medical specialists can provide many options for pain relief for back pain sufferers. One of the scariest options other than surgery, is the Epidural Steroid Injection (ESI). Preparing for an ESI can create severe anxiety in those who have not yet received injections, but once you have done it once you quickly realize it is nothing to fear.

Instructions

Difficulty: Moderately Easy

Things You’ll Need:

• Relaxation time
• Open Communication
• Anti-Anxiety Medication (Optional)
• Rest
• Ice

1. Speak with your physician about your options. If your doctor feels this is the best option for you make sure to discuss your fears and concerns. Write down any questions you have and ask them prior to your procedure.
2. If you are extremely nervous you can request anti-anxiety medication. It helps calm your nerves and relax prior to the procedure. Take all medication as prescribed and stop taking all medication that your physician tells you to (Typically includes medications like aspirin).
3. On the day of the procedure make sure to have someone who can drive you to and from the office. Make sure to arrive at the office at least 15 minutes prior to your appointment in order to fill out paperwork and pay any co-payment owed.
4. The Nurse, Physician Assistant or Physician may speak with you in advance to give an overview of previous discussions and to discuss any concerns you may have. The staff will have you complete a consent form before the procedure can begin.
5. The procedure typically only lasts 10-15 minutes. The ESI can be done on the Lumbar, Thoracic or Cervical areas of the spine. The Nurse will have you lay face down on a table and will expose and prep the area of the injection to make the injection site sanitary. You will also be hooked up to heart and blood pressure monitors so your vital signs can be tracked throughout the procedure.
6. The physician will numb the area of the ESI with Lidocaine first (the same kind of medication dentists use to numb your gums). This will numb the area and helps minimize (or eliminate) pain.
7. After you are numb the physician will begin the ESI. He/She will typically uses a live X-ray called Fluroscopy for navigation of the needle. This allows the physician to be accurate in navigating the spinal cord an vertebrae for the injection.
8. You will feel some pressure where the medication enters, then you may feels some burning or tingling around the targeted area. You also may feel additional pressure or sensation along the nerves that are affected by your injury. If the pain or discomfort becomes too intense make sure to let the physician know! He/She can slow the injection to help ease the discomfort. It is important to keep communicating with your physician so he/she understands your level of tolerance.
9. Once the injection is complete the nurse will place a band-aid on the injection site and the staff will monitor you for 15-20 minutes to ensure you do not have a medication reaction.
10. Have your driver take you home. Make sure to rest and if the injection site is painful or sore, place an ice-pack on the area to relieve the discomfort.

Tips & Warnings

• Many people feel sore for a few days. It can take up to two weeks to start to feel the pain-relief effect of an ESI.
• You may feel a little groggy or sick after the procedure and for days following.
• Get rest after your procedure- it will help the healing process.
• Some people are too nervous to have the ESI with anti-anxiety medication alone- Many physicians will perform the procedure under IV sedation or even general anesthesia. However, it is not necessary to be sedated or put out for the procedure.
• If you get a headache that seems intense make sure to notify your physician. You may have a slight spinal-fluid leak which can cause headaches or discomfort around the injection site.
• If you develop a fever or infection around the site notify your physician immediately.