Patient education: Epidural injection (The Basics)

What is an epidural injection? — An epidural injection can be used to treat a condition called "radiculopathy." This is the medical term for the pain, weakness, numbness, or tingling that happens when nerves coming from the spinal cord get pinched or damaged.

The doctor injects medicines into the space outside the covering of the spinal cord (figure 1). This is similar to an "epidural" that is used for pain relief during labor and childbirth.

Epidural injections can be given into different parts of your back:

●Cervical epidural injection – Used to help with pain in the head or arms.

●Thoracic epidural injection – Used to help with pain in the upper or middle back.

●Lumbar epidural injection – Used to help with pain in the lower back or legs.

How do I prepare for an epidural injection? — The doctor or nurse will tell you if you need to do anything special to prepare. Before your procedure, your doctor will do an exam. They might send you to get tests, such as:

●X-ray, ultrasound, or other imaging tests – Imaging tests create pictures of the inside of the body.

Your doctor will also ask you about your "health history." This involves asking you questions about any health problems you have or had in the past, past surgeries, and any medicines you take. Tell them about:

●Any medicines you are taking – This includes any prescription or "over-the-counter" medicines you use, plus any herbal supplements you take. It helps to write down and bring a list of any medicines you take, or bring a bag with all of your medicines with you.

●Any allergies you have

●Any bleeding problems you have – Certain medicines, including some herbs and supplements, can increase the risk of bleeding. Some health conditions also increase this risk.

You will also get information about:

●Eating and drinking before your procedure – In some cases, you might need to "fast" before surgery. This means not eating or drinking anything for a period of time. In other cases, you might be allowed to have liquids until a short time before the procedure. Whether you need to fast, and for how long, depends on the procedure you are having.

●What help you will need when you go home – For example, you might need to have someone else bring you home or stay with you for some time while you recover.

Ask the doctor or nurse if you have questions or if there is anything you do not understand.

What happens during an epidural injection? — When it is time for the procedure:

●You might get an "IV," which is a thin tube that goes into a vein. This can be used to give you fluids and medicines.

●You will get anesthesia medicines to numb the area where the doctor will give the injection. This is to make sure that you do not feel pain during the procedure. You might also get medicines to make you relax and feel sleepy, called "sedatives."

●The doctors and nurses will monitor your breathing, blood pressure, and heart rate during the procedure.

●The doctor might use a continuous X-ray called "fluoroscopy." This is to help make sure that the medicines are injected into the right place. The doctor might also inject a dye to see where to give the medicine.

●The doctor will place a needle through your skin and inject the medicine into a space near your spine. Then, they will remove the needle and cover the area with a clean bandage.

●The procedure takes 15 to 30 minutes.

What happens after an epidural injection? — After your procedure, the staff will watch you closely for a short time. It might take a few days before you feel the effects of the epidural injection.

Before you go home, make sure that you know what problems to look out for and when to call the doctor. Make sure that you understand your doctor's or nurse's instructions. Ask questions about anything you do not understand.

For the rest of the day after your procedure:

●Try to rest. Limit activities like exercise or driving.

●The doctor might recommend an over-the-counter pain medicine. These include acetaminophen (sample brand name: Tylenol), ibuprofen (sample brand names: Advil, Motrin), and naproxen (sample brand name: Aleve).

●Ice can help with pain and swelling. Put a cold gel pack, bag of ice, or bag of frozen vegetables on the injection site area every 1 to 2 hours, for 15 minutes each time. Put a thin towel between the ice (or other cold object) and the skin.

What are the risks of an epidural injection? — Your doctor will talk to you about all of the possible risks, and answer your questions. Possible risks include:

●Bleeding

●Infection

●Headache

●Nerve injury

When should I call the doctor? — Call for emergency help right away (in the US and Canada, call 9-1-1) if:

●You can't move your arms or legs.

Call for advice if:

●You have a fever of 100.4°F (38°C) or higher, or chills.

●You have redness or swelling around the injection site.

●You have a headache.

●Your arms or legs are numb, weak, or tingly.

More on this topic

Patient education: Radiculopathy of the neck and back (including sciatica) (The Basics)