Epidural injection for back pain: Is it right for you?
If you have chronic back pain, you know the toll it can take on your life. It interferes with activities you enjoy, and makes even basic tasks difficult or impossible.
Having epidural injections for back pain are increasingly common. They are a great option when other treatment options haven’t worked. But how do they work? And what are the pros and cons?
Here’s an overview so you can consider whether this treatment is a good way to get back to your normal lifestyle.
How epidural injections for back pain work
Getting epidural steroid injections can ease various types of back pain, such as a herniated disc (slipped disc), as well as back and leg pain caused by sciatica (trapped nerve).
At Ravenscroft Health, we offer fluoroscopic guided injections. Fluoroscopy uses a ‘contrast dye’ that’s injected into your body. It makes the delicate spinal structures clearer for doctors to see on a real-time X-ray display.
Using fluoroscopic guidance means the pain relieving medication the spinal injection delivers is highly targeted.
The substance injected is normally a combination of:
- A corticosteroid to reduce inflammation
- A local anaesthetic for quick relief in the affected area.
We usually inject this liquid into the epidural space, a gap that surrounds the spinal cord and nerve roots.
We can give injections at different places along the spine, depending on your symptoms. For example, it could be between two vertebrae, into the side of the spine, or near the base of the spine (a lumbar epidural).
What to expect
Pain injections can relieve symptoms, but they don’t cure the underlying problem. Rather, they help you manage the pain for a few weeks or months.
Pain relief often makes it easier to do physical exercises as part of your rehab. Keeping active will likely improve your pain and make it less likely to return.
At your appointment at the clinic or hospital you will lie down on an operating table, either on your front or your side. If you need medication during the procedure, we’ll normally use a thin tube called a cannula which goes into a vein in your hand.
You may be asked to remove some of your clothes for the procedure. If you are having a fluoroscopic guided injection, you may be asked to remove jewelry, eye-glasses, and zippered items, as these might interfere with the X-ray images.
We numb the injection site on your back with local anaesthetic. Then we use fluoroscopy and an X-ray display to guide the epidural needle to the precise area.
You should only feel slight pressure rather than any pain when we position the epidural needle and begin the injection procedure. The whole process takes about 30 minutes.
Benefits
Epidural corticosteroid injections are a minimally invasive way to relieve acute or chronic back pain for many people. The other advantages may include:
- Fast recovery time
- Reduced need to take pain medicines
- Enables you to increase physical activity
- Improved sleep
- If it’s effective, you’ll be less likely to need invasive surgery in the future.
If you choose a fluoroscopic guided spine injection, you will also benefit from the fact the pain relief this offers is highly targeted.
Risks
As with any injection, there is a remote risk of infection (less than 1 in 100,000). We recommend you contact your GP or visit the A&E if the area becomes painful and hot afterwards, particularly if you feel unwell in yourself.
Hot flushing sensations after a steroid injection (more common for women) usually settle in a few minutes. If you have diabetes, you may experience a rise in your blood sugar level for a few days after the injection.
Steroids may also cause transient mood changes, disturbances to the menstrual cycle and on occasional skin site depigmentation. Steroid injections usually take a week or so to have an effect and can ease symptoms for a few months.
How to prepare
You do not have to follow a special diet or have any special preparation for a fluoroscopic guided spine injection.
If you think you are allergic to local anesthetic, steroid, iodine or to the X-ray contrast, please notify your clinician.
Recovery
During the day of the procedure you may feel comfortable because of the local anaesthetic.
After the injection, you may feel more discomfort than usual at the site of injection for 24 to 48 hours. Over-the-counter painkillers such as paracetamol are usually enough to manage this.
We recommend that patients rest for 1-2 days following a steroid injection. As with many minor procedures, you should be able to go home the same day.
You will rest in a recovery room, possibly lying flat for a short while. We’ll then check that you’re feeling alright and make sure you can stand and move about.
Arrange for a taxi or someone to drive you home, and try to have someone stay with you overnight after your injection.
You may not feel the benefits of an epidural injection for several days. You can gradually increase how much you do as your pain improves.
You might find that the injection doesn’t give you enough pain relief, or its effects are short term. In these cases, you could consider repeat injections or a different treatment.
See a pain management specialist
Our specialist staff at Ravenscroft Health are experts in pain management and rehabilitation. Your GP may refer you or you can book a private appointment with a consultant at our pain clinic. We will guide you on how to get the best treatment to improve your quality of life.
