Epidural Injections
(Cervical, Thoracic, or Lumbar)


What is the epidural space?

The membrane that covers the spine and nerve roots in the neck is called the dura membrane. The space surrounding the dura is the epidural space. Nerves travel through the epidural space to the neck, shoulder and arms. Inflammation of these nerve roots may cause pain in these regions due to irritation from a damaged disc or from contact with the bony structure of the spine.


What is an epidural injection and why is it helpful?

An epidural injection places anti-inflammatory medicine into the epidural space to decrease inflammation of the nerve roots, hopefully reducing the pain in the neck, shoulders and arms. The epidural injection may help the injury to heal by reducing inflammation. It may provide permanent relief or provide a period of pain relief for several months while the injury/cause of pain is healing.


What happens during the procedure?

The patient is placed on an x-ray table and positioned on their abdomen in such a way that the physician can best visualize the area using x-ray guidance. The area to injected is cleansed using a solution called Betadine. Next, the physician injects a small area of skin with numbing medicine. This medicine stings for several seconds. After the numbing medicine has been given time to be effective, the physician directs a small needle, using x-ray guidance into epidural space. A small amount of contrast (dye) is injected to insure proper needle position in the epidural space. Then an anti-inflammatory (cortisone/steroid) is injected.


What happens after the procedure?

Patients are then moved to the recovery area where they are monitored for 20 minutes. Patients are then asked to report the relief they experience during the next week by calling the clinic. A follow-up appointment may be made in 3-4 weeks. A repeat injection may need to be scheduled if indicated.


General Pre/Post Instructions

Patients may eat a light meal before the procedure. If a patient is an insulin dependent diabetic, they should take their insulin and eat. Patients may take their routine medications. (e.g. high blood pressure and oral diabetic medications). If you are on Coumadin (Warfarin), Plavix (Clopidogrel), Lovenox, Pletal (Cilostazol), Effient (Prasugrel), Teclid ( Ticlopidine), or Pradaxa (Dabigatran), notify the office so that special instructions may be given. If you are allergic to iodine, contrast, or medical dye, please inform the office. Patients can expect to be at the facility approximately 1 1/2 hours. A driver must accompany the patient and be responsible for getting them home. No driving is allowed the day of the procedure. Patients may return to their normal activities the day after the procedure, including returning to work unless instructed otherwise by the physician.