Epidural Injection

What is an Epidural Injection?

The space surrounding the spinal cord is known as the epidural space.  An epidural injection involves a mixture of local anaesthetic and steroid being injected into the space surrounding the spinal cord.

Why do I need an Epidural Injection?

Epidural injections are an effective way to help relieve lower back pain and radiating leg pain often associated with inflammation.  Epidurals can also be used to reduce neural tension and therefore can be used to help in the treatment of impaired hamstring or calf function.

Pain relief can occasionally be achieved with this procedure for acute lumbar disc herniations and with acute discogenic pain.  Some sufferers of spinal stenosis may also gain relief from an epidural injection.

Procedure

The patient will be asked to lie face down on the CT table.  Once the patient is in position an antiseptic solution will be used to clean the patient’s back.  A Radiologist specialising in this procedure will use the CT as a guide to place the needle into the epidural space.  The position of the needle will be confirmed using a small amount of contrast (X-ray dye) or air injected into the area.  A combination of cortisone and local anaesthetic will then be injected.  You may experience some discomfort for a short while until the local anaesthetic starts to work.

The procedure takes about 30 minutes.

The cortisone component of the injection usually starts to work about 2-3 days after the injection.  The effects of the injection last on average 3-6 months.

Are there any risks or side effects?

There are always risks and/or side effects associated with any treatment or procedure.  Overall however, the risks are low but can include:

• Soreness and bruising at the site of injection
• Dural puncture which can result in headache
• Temporary leg numbness or weakness
• Bleeding
• Infection

Very rare side effects:

• Loss of bladder control
• Nerve damage

Post Procedure

It is very important that you have someone to accompany you home. We advise that you do not drive for a minimum of 6 hours after the procedure.

You may have a little discomfort at the injection site, and there may be some bruising.  Taking paracetamol (eg: Panadol) and applying ice to the affected area may help relieve these temporary symptoms.

A headache can generally be relieved by taking Paracetamol (eg: Panadol)  and resting.  This will normally resolve within 48 hours.

The local anaesthetic may temporarily make the legs feel numb (or sometimes weak).  This usually settles within 4-6 hours depending on the local anaesthetic used.

You should refrain from exercise or strenuous activity for up to one week after the procedure depending on what your doctor has told you.  Please follow your treating doctors advice on how best to recommence pre-treatment activities.

If after 48 hours following your injection you are experiencing any fever, swelling, localised heat or increasing pain you should contact your doctor without delay.

Things we need to know from you

Please inform the Radiology staff of any of the following:

1. If you have allergies to any medication, anaesthetic agent or X-ray contrast
2. If you are taking any blood thinning medications (Aspirin, Warfarin, Clopidogrel etc)
3. If you are feeling unwell or need to cancel your appointment please ring our office as soon as possible on (08) 8229 2100

Note to female patients: If you are pregnant, or suspect you may be, or if you are breast feeding please advise us before your appointment.

Important things you must bring to your appointment

• A referral from your doctor
• Medicare card
• Pension/Concession card
• Any previous films/x-rays
• WorkCover/Motor Vehicle Accident claim details (if applicable) i.e. claim number, name of employer or insurer

Concerns

Please feel free to contact our staff at any time if you have any questions or concerns on (08) 8229 2100