Image Guided Spine Pain Treatment

Epidural
What Is a Cervical, Thoracic or Lumbar Epidural Injection?

Your doctor may have suggested you have a Thoracic/Cervical/Lumbar Injection. This procedure can help relieve low back pain or upper back and arm pain by reducing inflammation.

A Way to Relieve Pain
An epidural injection won’t stop all pain. But it can reduce pain and break the pain cycle. This cycle may begin when pain makes it hard to move. Lack of movement can then slow down healing. By getting you back on your feet, the injection can help speed your recovery. Some people may feel more relief from an injection than others. And some people may need more than one injection to get relief.

Understanding Anatomy
Learn more about your back anatomy. That way, you can understand how an injection can help relieve or locate your pain.

Vertebrae are the bones that stack up to form the spine.

Disks are “cushions” that provide padding between the vertebrae. A damaged disk can lead to inflammation and pain.

The spinal canal is a tunnel that’s formed within the stacked vertebrae. Nerves run through this canal. The nerves are wrapped by a thin layer of tissue.

A nerve root is the part of a nerve that leaves the spinal canal. Inflamed nerve roots can lead to back pain.

The sciatic nerve is a nerve that extends down to the leg. When its roots are inflamed, buttock and leg pain often result.

Possible Injection Sites
Where the medicine is injected in your spine depends on the goal of the injection. For pain relief, the injection is done in the epidural space. This is the area that surrounds the nerves within the spinal canal.

Your Injection Procedure
An epidural injection is an outpatient procedure. Before your injection, your doctor will ask you questions about your health. He or she will discuss how you need to prepare.

Getting Ready
You doctor may ask you to prepare by doing the following:

Provide a list of all medicines you take, including blood thinners. (You may need to stop taking some of them before injection.)

Bring any requested CT or MRI images on the day of the procedure.

Risks and Complications

• Spinal Headaches
• Bleeding (rare)
• Infection (rare)

During the Procedure

• The injection takes just a few minutes although extra time is needed to prepare.
• You lie on your stomach.
• Your back is cleaned and is covered with sterile towels.
• Medicine is given to numb the skin near the injection site.
• Fluoroscopy (x-ray imaging) is used with a contrast “dye” injected into your back. This will help the doctor get a better image.
• A local anesthetic (for numbing), steroids (for reducing inflammation), or both are injected into the epidural space.

After the Procedure
You may need to spend up to an hour in a recovery area. You may notice some side effects. They should go away in the first few minutes to days. They can include:

• Briefly increased pain
• Headaches
• Trouble sleeping
• Numbness

You do not need to stay in bed when you get home. In fact, it’s best to walk around if you feel up to it. Just be careful about being too active. Even if you feel better right away, avoid activities that may strain your back. Keep in mind that some patients may feel increased pain at first. It usually goes away within a few days.

The First Few Days
An injection to reduce inflammation takes a day or two to work. There may even be more pain at first. Follow up on treatment with your doctor.

• Take walks when you feel up to it.
• Rest if needed, but get up and move around after sitting for half an hour.
• Don’t exercise vigorously.
• Return to work or other activities when your doctor says you’re ready

When to Call Your Doctor
Call right away if you notice any of the following symptoms:

• Severe pain or headache
• Fever or chills
• Loss of bladder or bowel control
• Redness or swelling around the injection site

Lifting Safely
No matter how strong your back is, lift safely to prevent injuries. Make it a rule to follow these steps:

• Stand close to the object
• Bend at hips and knees. Keep your ears shoulders and hips in line
• Hold the object to your body
• Press down with your feet and lift using legs, not your back.