Epidural Steroid Injections
An Epidural Steroid Injection (ESI) is an easy, secure, and efficient non-surgical treatment that engages the injection of a steroid medication alike to cortisone into the Epidural Space of the “foothills”. The epidural space is the segment of the “foothills” where inflamed nerves are located. The objective of this process is to diminish inflammation and consequently reduce pain. Executed by Foothills pain management, ESI is a minimally invasive method used to reduce a range of aching conditions, together with chronic pain anywhere in the “foothills”.
Your referring GP has requested that you have an epidural steroid injection. The following is a explanation of the process and a narration of the possible problems, so that you can give knowledgeable approval to have the procedure. ESI is an invasive process with a few rare risks, so you will require giving informed consent. Local anesthesia (numbing medicine) will be injected below your skin. A needle will be positioned with fluoroscopic (x-ray) supervision into the “foothills” along the fibrous fluid-containing sac that contains the lumbar nerve roots. A little of contrast (x-ray dye) will be injected to verify accurate needle position. Then an injection of steroids will be made into the same position. You will then be checked for probable problems in the hospital for a short duration after the process until you are discharged. You will be able to eat and drink as well as use the bathroom while in the hospital after the procedure. Most problems of epidural steroid injections are rare and the process is not dangerous.
Injection Procedure :
Even though there are several methods used for Epidural Steroid Injection, the most familiar practice engaged by foothills pain management specialists now is with X-Ray guidance (fluoroscopy), frequently with the patient lying on his or her stomach. Dr. Mehta make use of fluoroscopy for all of his ESI actions. The injection is carried out under local anesthesia and, on occasion, with intravenous sedation. Patients are not totally sedated or wholly asleep for this process because it is needless and insecure to do so. The process generally takes no more than 5-10 minutes, followed by a short 15-20 minute recovery prior to discharge home.
Conditions that responds to Epidural Steroid Injection :
For more than four decades, ESI is used to efficiently treat chronic neck and back pain and also a range of other circumstances. The widespread diagnoses treated with ESI comprise herniated or bulging discs, “foothills” stenosis, and recurrent pain following “foothills” surgery. Additional conditions that may also react to ESI include spondylolisthesis (slippage of the vertebral column) and post-herpetic neuralgia (pain after shingles).
Will injection hurt?
The injection of local anesthetic (numbing medicine) at the start of the process may hurt some, but ESI is an otherwise regular process that is vastly bear by patients falling in age from the mid-teens to ninety years old. If you are worried or afraid about pain throughout the process, kindly converse with Dr. Mehta the risk for you getting intravenous sedation.
It is necessary that you don’t eat or drink for at least eight hours on the day of injection prior to your schedule procedure. If you are planned to get sedation at some stage in the process, you necessarily have someone obtainable to drive you home. If you regularly take drug meant for high blood pressure or some sort of heart condition, it is extremely vital that you take this drug at the usual time with a sip of water prior to the process.
If you are taking some sort of drug that may thin the blood and may reason to extreme bleeding, you ought to converse with your doctors whether to cease this drug before the process. These anticoagulant drugs are frequently given to guard a patient against stroke, heart attack, or other vascular occlusion event. As a result the judgment to cease one of these drugs is not made by the pain management physician but instead by the primary care or specialty physician (cardiologist) who prescribes and supervises that drug. Illustrations of drugs that may possibly encourage surgical bleeding comprise Coumadin, Plavix, Aggrenox, Pletal, Ticlid, and Lovenox.
What can I look forward after the injection?
You may observe a little decrease in your sting for the initial 1-2 hours past the injection if local anesthetic is injected with the steroid. When this anesthetic wears off, your ache will revisit as it was previous to the process. Even though pain relief with ESI usually takes place in 3 – 5 days, a few patients notice progress prior to or after this stage. Diabetic patients must be attentive for a grow in blood sugar during the initial few days following injection and necessarily keep an eye on blood sugar accordingly.
After Injection :
Following discharge home, you must schedule on trouble-free rest and relaxation. If you have sting at the injection place, appliance of an ice pack to this part can be useful. If you get intravenous sedation, you must not drive at least for 8 hours. Patients are usually guided to go home and not come back to work after this sort of injection. A good number of people do go back to work the next day.
Injections needed during treatment :
A usual injection series consists of three injection sessions through a gap of two weeks between both sessions. On the other hand, the quantity of injections that you may perhaps need depends on your reaction to every individual injection. If there is no pain after one injection, you will possibly not require at all extra treatment. Alternately, if you have completely no pain relief past two injections, Dr. Mehta may possibly propose a special treatment for your pain. Kindly remember that the substitutes to Epidural Steroid Injection might, in a few cases, engage hugely different treatments like Facet Joint Injection, Sacroiliac Joint Injection, Percutaneous Disc Decompression or even surgery. If you are unsure whether you must have your next procedure or if you think that a different sort of injection or treatment should be considered, kindly get in touch with Dr. Mehta’s team well in advance of your next meeting to talk about your condition.
Side effects and complications :
Negligible side effects through the injected drugs are common and possibly comprise nausea, itching, rash, facial flushing and sweating between other things. Few patients observe a bit increase or deterioration of their pain for the first day or two following injection. Luckily Epidural Steroid Injection has an enormously excellent safety profile, and serious problems are reasonably rare. Same like some other medical process, there are likely complications linked with ESI. Dr. Mehta will talk about these concerns with you, and you will be requested to cautiously read and sign a permission form prior to any process is carried out.
What are the probabilities that this treatment will aid my pain?
Majority studies explain that this treatment assists reduce pain for around half of the patients treated. The degree and period of pain relief are unpredictable and rely on numerous different aspects that include the primary diagnosis or situation being treated, period of symptoms prior to treatment, whether earlier back (neck) surgery has been carried and other factors.
If pain revisits, can the injections be repeated :
YES! This treatment can certainly be repeated if it was useful for your pain earlier. Still there is a little flexibility in the duration of repeat injection, Dr. Mehta will most likely want you to wait for at least four to six months past your previous injection. This concern can be conversed at some point in a follow-up office visit.