Epidural Injection (lumbar or cervical)

Why have an epidural injection?

Injecting a combination of local anaesthetic and steroid around the area where nerves leave the spinal cord to reach other parts of the body can assist in decreasing swelling and inflammation. This allows greater freedom of movement of the muscles in the affected area and alleviates pain.

Diagnosis

The symptoms are very similar to those that lead to discectomy or decompression. They can include back or leg pain (which can vary from a mild ache to excruciating discomfort), numbness, muscle weakness and a tingling ('pins and needles') sensation. Epidural injections can help provide short-term pain relief for people with chronic back pain or sciatica (shooting pain down one or both legs).

The consultant specialist (this can be a consultant spinal surgeon or a consultant anaesthetist specialising in pain management) may have an x-ray or MRI scan taken of a patient's back to determine the cause and severity of the symptoms or to rule out any other problems that may be present. When the cause is not highly prominent or the condition not too severe an injection (in conjunction with an appropriate phyical therapy programme) may be the best option to alleviate the symptoms and can be an alternative to surgery in milder cases.

Treatment

The injection itself is a short procedure carried out under local anaesthetic. Patients will be taken to the treatment room (or sometime the operating theatre) where they will lie down, either on their front or side, in as comfortable a position as possible.

The surgeon or anaesthetist carrying out the procedure will clean the back in preparation for the injection using antiseptic solution. Some local anaesthetic may be injected into the skin to reduce any discomfort caused by the procedure. As patients are awake for this type of procedure a pushing sensation and pressure may be felt when the needle is inserted into the right place and the solution then injected.

Shortly after the injection the patient will be taken to the recovery area where close monitoring will continue until the patient is ready to move to a chair and start walking around. Sometimes after treatment patients can feel a warm or tingly sensation in the back or legs but this should go away quickly.

The injection can sometimes take a week or two to work fully and this is quite normal. After the injection itself the pain relief can be a result of the local anaesthetic and previous symptoms can return for a brief period before the epidural injection has taken its full effect.

After treatment

Patients will be discharged home on the same day as the epidural injection. Driving must be avoided for at least 24 hours after discharge from hospital.

A key step to a successful recovery is ongoing exercise that is appropriate to each individual. The consultant specialist and the physiotherapists will be available to discuss this with each patient and set out an appropriate rehabilitation programme.