The membrane that covers the spinal cord and nerve roots is called the dura membrane. The space that surrounds the dura is called the epidural space. This is the area where the needle is inserted and anti-inflammatory medication or steroids are injected during an epidural procedure. This medication then bathes the nerve roots, and reduces pain or swelling and inflammation.
Patient Preparation
According to Dr. Paul Dreyfuss, a clinical professor at the University of Washington, patients are allowed to eat a light meal within a few hours prior to the procedure. Individuals who are suffering from diabetes should coordinate their pre-procedure meal with a clinician and the physician who is treating the diabetes. Patients can take their routine medications, but should not take any pain medications or anti-inflammatory medications on the day of the procedure.
Procedure
According to Back.com, many hospitals and medical centers have pain management physicians--physiatrists, anesthesiologists, radiologists, neurologists or surgeons--who are responsible for the administration of epidural injections to treat back pain. The procedure is an outpatient process that involves some mild sedative, correct positioning for insertion of the needle and injections of a local anesthetic, followed by X-ray guidance into the epidural space. Once the steroid or anti-inflammatory medication is injected into the space, the physician removes the needle, cleans the site and covers it with a bandage.
Patient Experience
According to RadiologyInfo.org, patients usually do not feel the procedure because a local anesthetic is first used to numb the injection area. Some may feel tingling or pressure when the injection is administered. Depending on the amount of swelling in the epidural space and the irritation of the nerve roots, patients may experience a burning sensation or some mild discomfort that usually disappears as soon as the administration is completed. Patients should not feel any sharp pain or discomfort from the procedure.
Risks
According to MedlinePlus, these types of injections and anesthetic administration are generally safe. However, there have been reports of complications that include severe headache, a drop in blood pressure, nerve damage, infection, allergic reaction, bleeding into the spinal column, difficulty urinating and seizures.
Results and Restrictions
According to Brigham and Women's Hospital, most individuals do not feel pain relief immediately after the procedure. It can take up to 48 hours for the effect to gradually take place. Steroids may have peak effectiveness in two weeks, and anesthetics may last up to several months. Patients are not allowed to drive for the remainder of the day of the procedure because of the lack of feeling and balance they experience. Patients are not allowed to apply any heat to the area for the day, and cannot soak in a tub, pool, jacuzzi or other water for the remainder of the day of the procedure. There are no restrictions on medication, food or drink afterward.
