Back Pain Relief With Epidural Injection

Your attending doctor has suggested that you give an epidural injection in connection with your pain complaints.

What is an epidural injection?
The epidural space is located in the spinal canal and is bounded by the vertebrae and the meninges. In the epidural space are, among other things, the nerves coming from the spinal cord. It may be necessary to inject medication, eg anesthesia or anti-inflammatory drugs, into this area. This reduces irritation of nerves and thus also the pain. The injection can provide relief for example with a hernia, narrowing of the spinal canal and low back pain.

The epidural space runs from the bottom of the skull to the tailbone; the injection
can take place in the entire trajectory of the spine. The location of your pain complaints determines where the injection is given:

• at the level of the neck (in medical language: cervical level),
• at the height of the chest (thoracic level),
• at the low back (lumbar level),
• at the level of the sacrum (caudal level).

Preparations
The preparations below are important for a smooth course of treatment.

• You do not have to be sober for this treatment.
• If you have a blood clotting disorder or are using blood-thinning medicines, you should report this in advance so that appropriate measures can be taken. With some blood thinners, including acenocoumarol, phenprocoumon, and Plavix, you should stop for several days in consultation with the anesthesiologist. Your blood (INR value) is sometimes checked prior to treatment. If the coagulation value is not in order then the treatment is postponed to a different date.
• If you are pregnant or suspect, talk to the anesthesiologist beforehand if the treatment can continue.
• If you are hypersensitive or allergic to iodine, plasters, contrast or anesthetic fluid, you must report this before starting treatment.
• Jewelry and money can best be left at home in connection with loss and/or theft.
• After the treatment, you may not actively participate in traffic the same day. Make sure that you are taken home by a supervisor after the treatment.

Therapy
On the agreed day and time you report at the desk of the ambulatory center, route 140. There you will receive surgical clothing. The surgical clothing is required for sterility in the treatment room at the operating department. The nurse will then take you to the treatment room on a stretcher. Most patients receive an epidural injection in a sitting position.

At the site where you receive the epidural injection, the skin is disinfected, covered with sterile cloths and locally anesthetized. This prick is just as painful. The doctor then looks for the epidural space with a special needle. When the needle has reached the correct position, the drugs are injected, usually anesthetic fluid and prednisone.

After this, you will be taken to another room for follow-up of blood pressure and heart rate.
After the treatment, you will return to the Ambulatory Center. You can put on your own clothes again and if everything goes as planned, you can return home smoothly.

Length of time
The procedure in the operating room takes about 10-15 minutes. All in all, you must count on a stay of at least two hours in the hospital.

Result
A decrease in pain is usually noticeable after 3-7 days and persists for up to several months. It is possible that the pain has several causes so that an epidural injection is not always sufficient. In that case, a repeat or additional treatment is required.

After treatment
The first hours after the injection you may suffer from a temporary reduction of feeling and strength in the arm or leg.
Some side effects of a temporary nature: If prednisone is administered in women, they may suffer from hot flushes or menstruation may become disrupted for a short time. People with diabetes sometimes notice that their blood sugar values ​​are a few days higher than normal.

Complications
It can, in exceptional cases, prevent the spinal cord from being punctured. This can lead to headache complaints. In a single case, the area of ​​the insert can show signs of infection (redness, pain or fluid secretion).
If you experience headaches, fever or infection of the insertion opening, please contact your doctor. In spite of all precautions, in rare cases, an infection occurs which can lead to meningitis or a build-up of the back. This accumulation will often have to be relieved by means of an operation.