The membrane that covers the spinal cord and nerve roots in your spine is called the dura membrane. The space surrounding the dura is the epidural space. Nerves travel through the epidural space into your mid back and along the ribs. Inflammation of these nerve roots may cause pain in these regions du to irritation from a damaged disc or from contact in some way with the bony structure of the spine.
An epidural injection places anti-inflammatory medicine into the epidural space to decrease inflammation of the nerve roots, hopefully reducing the pain in your mid back or around your rib cage. 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 your pain is healing.
An IV will be started so that relaxation medication can be given. You will be placed lying on your side on the x-ray table and positioned in such a way that your doctor can best visualize your back using x-ray guidance. The skin on your back will be scrubbed using 2 types of sterile scrub (soap). Next, the physician will numb a small area of skin on your low back with numbing medicine. This medicine stings for several seconds. After the numbing medicine has been given time to be effective, your doctor will direct a small needle using x-ray guidance into the epidural space. A small amount of contrast (dye) is then injected to insure proper needle position in the epidural space. Then, a small catheter will be placed into the epidural space and advanced up to the area of abnormality. Then, a mixture of numbing medicine (anesthetic) and anti-inflammatory (cortisone/steriod) will be injected.
You will go back to the recovery area where you will be monitored for 30-60 mins. You will then record the relief you experience during the next week on a post injection evaluation sheet (“pain diary”). This will be given to you when you are discharged home. You will also be given a follow-up appointment for a repeat block if indicated. These injections are usually done in a series of three (3), about two (2) weeks apart. PLEASE mail this completed “pain diary” to the doctor that is performing the procedure and their office will contact you if it is necessary to change your next appointment.
You will NOT be able to drive the day of your procedure. Your back may feel weak and numb for a few hours.
You should eat a light meal within a few hours of your procedure. If you are an insulin dependent diabetic, do not change your normal eating pattern prior to the procedure. Please take your routine medications (i.e. high blood pressure and diabetic medications). If you are on Coumadin (blood thinners) or Glucophage (a diabetic medicine) you must notify this office so the timing of these medications can be explained. You will be at one of the hospitals approximately 2-3 hours for your procedure. YOU WILL NEED TO BRING A DRIVER WITH YOU. You may return to your normal activities the day after the procedure, including returning to work.
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