During a thoracic epidural steroid injection you will lie face down on an X-ray table. The targeted area will be sterilized in order to reduce the possibility of infection.
A pain management specialist will inject a local anesthetic to numb the area around your mid to upper back. This typically stings for 2-5 seconds. The specialist will then use a needle to access the thoracic epidural space using X-ray guidance.
Once the needle is in place, contrast material is used to confirm the location around the inflamed nerves. Once this is determined, your provider will slowly inject medicine to the targeted region.
A thoracic ESI is an outpatient procedure, meaning you can go home the same day. After the injection is performed, you will be monitored in a recovery bay for approximately 30 minutes. There, your vital signs will be assessed by a nurse and your pain relief will be documented.
If a side effect from the procedure is seen, a certified medical professional will be on hand to address the issue. If there are no complications after the procedure, discharge instructions will be given to you and you will be asked to keep a record of your pain relief for the next several days.
- If you are taking a blood thinning medication, please ask the physician who prescribed the medication for directions on stopping it prior to scheduling the procedure.
- Please tell the doctor or staff about any allergies you have including medications, seafood, shellfish, latex, or x-ray dyes.
- Please arrange for someone to drive you home after the procedure. You may be given mildly sedating medication, and it will be unsafe to drive or operate heavy machinery until the following day.
Thoracic ESIs are generally safe injections. There are small risks which include: pain around the injection site, bleeding, and infection. Other risks include lightheadedness due to low blood pressure or a severe headache caused by spinal fluid leakage. If either of these symptoms is noted after the procedure, please seek advice from a medical expert. The most commonly reported event after a thoracic ESI is soreness around the injection site.
Because steroid medication is used, you may also experience flushed skin, insomnia, or a few days of increased blood sugar. Be sure to monitor your blood sugar after this injection if you are diabetic or take insulin.
Some people experience significant pain relief after only one injection. If you still have pain, your doctor may order an additional injection to increase the effects.
These injections typically occur two to four weeks apart. Epidural steroid injections start working within two to seven days. Pain relief can last several days to a few months or longer. These injections can be performed upward to a few times a year if inflammation around the spinal nerves continues to occur.