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Nerves from the upper and lower limbs enter the vertebral column and pierce the dural sac to reach the spinal cord.
For various reasons these nerves can become irritated as they enter the vertebral column and cause pain in the
upper and lower limbs. This pain is felt as shooting down the lower limb and is referred to as nerve root pain,
or technically, radicular pain.
What is Epidural Steroid Injection?
The term epidural steroid injection refers to the injection of corticosteroids into the epidural space of the
vertebral column as a means of treating pain caused by irritation of the spinal nerves. There are diagnostic
and therapeutic ways epidural steroid injection can help:
- The first benefit is that some leg pain involves the inflammation of one or more of the nerves,
their covering, or their roots, in the neck or back. The injection of steroids directly into the part of
the spinal column called the epidural space is thought to aid in reducing inflammation.
- The second benefit is that the anesthetic/cortisone solution blocks the pain long enough to allow the
body to begin the process of repairing itself.
- The last benefit involves the accurate diagnostic information provided by the nerve block when it relieves
your pain.
How is an Epidural Steroid Injection Administered?
A local anesthetic will be injected into the skin and underlying tissues to decrease the discomfort of introducing
the epidural needle. Once the local anesthetic is working, the epidural needle is advanced into the epidural
space, using the bones as landmarks to ensure the needle is in the right place. When the needle is in the
epidural space, a syringe containing the corticosteroid solution is connected to the needle. After making sure
the needle is not in a blood vessel or in the spinal fluid, Dr. Columbus injects the solution slowly. The
corticosteroid will be injected in a form that may include a saline solution and/or a local anesthetic, however,
the dosage and the volume of the steroid and the other components will vary according to her judgment.
What are the Typical Risks of Epidural Steroid Injection?
With any operation or injection procedure there are risks. In the case of epidural steroid injection, these
risks are small. The most common side effect is a temporary increase in pain. It occurs in about one percent
of epidural steroid injections. Headaches can also occur, with an incidence of one percent. If you are allergic
to one of the additives in the steroid solution, you may experience a hot flush and develop a rash. As with any
injection with the skin, it is possible for bacteria to gain entry causing an infection. There is also a risk
of bleeding, which is why it is very important to follow your pre-injection instructions and discontinue any
medications that may thin your blood and cause you to bleed easily. It is also theoretically possible that
the nerve could be temporarily or permanently irritated secondary to the procedure.
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