Image Guided Epidural Injection.
Key Information
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An epidural injection is a common type of injection with which medication is injected into the space around the spinal cord, also known as the epidural space. The epidural injection is used to provide temporary or prolonged relief from pain or inflammation.
The epidural space is the outermost part of the spinal canal, located outside the dural membrane. Steroids, anaesthetics and anti-inflammatory medications are typically delivered in an epidural injection. The injection may reduce pain and swelling in and around the spinal nerve roots, as well as around damaged nerves which in time may heal. The canal runs the entire length of your spine and therefore injections into this space can treat multiple levels.
Dr Sanjay Nadkarni uses the assistance of a fluoroscopic image guidance for precision when performing these injections.
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Patients will be seen for a consultation prior to their initial injection.
Patients may be asked to fast before their appointment. Your doctor will advise you at your initial consultation.
Patients are to advise us if they are taking any medications that thin the blood. For example warfarin or aspirin.
Patients are required to bring all previous imaging at the time of consultation and injection procedures.
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The epidural injection itself takes about 20 minutes. The skin around the joint is cleaned with antiseptic solution. A fine needle is injected under image guidance. The epidural space is injected with a mix of local anaesthetic and steroid. You may feel pressure or tingling.
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Immediately after the injection, you may feel your legs slightly heavy and may be numb. You may notice that your pain may be gone or quite less, due to the local anaesthetic injected and the sensation will last only for a few hours. Your pain will return and you may have a “sore back” for a day or two due to the mechanical process of needle insertion as well as initial irritation form the steroid itself.
The onset of pain relief varies between 2 – 14 days following the injection.
You will need to lay FLAT on for the rest of the day.
You need to avoid any heavy lifting or strenuous activity for the next week.
”The reception was so nice, a breath of fresh air after being turned down by multiple receptionists and we all know how specialist receptionist can be …Awesome experience straight away. So easy to get in! They understand what severe pain is!
Dr Nadkarni came to do the shot. Spoke clearly through the whole process which really put me at ease and every feeling he said I would feel happened as he said it would while doing the procedure.”
— Stuart E, 2024
FAQs
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There is some discomfort involved during the injection, however, we do administer a local anaesthetic prior to the injection, which will help.
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No please have someone drive you to and from your appointment.
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You should be able to unless the procedure was complicated. Usually you will feel some back pain or have a "sore back."
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The immediate effect is usually from the local anaesthetic injected. This wears off in a few hours.
The cortisone starts working in about 3 to 5 days and its effect can last for several days to a few months to sometimes years.
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Generally speaking, this procedure is safe. However, with any procedure there are risks, side effects, and possibility of complications.
The most common side effect is pain – which is temporary. The other risk involve spinal puncture with headaches, infection, bleeding inside the Epidural space with nerve damage, worsening of symptoms etc.
The other risks are related to the side effects of cortisone: These include weight gain, increase in blood sugar (mainly in diabetics), water retention, suppression of body’s own natural production of cortisone etc.