Spinal Corticosteroid Injection
En Español (Spanish Version)

Definition
A spinal corticosteroid injection places corticosteroids into tissue around the spine. Corticosteroids are drugs that reduce painful swelling and irritation. They are injected into the back with a needle.

Reasons for Procedure
The procedure is done to:

  • Reduce pain caused by swelling and irritation around the spine
  • Improve physical function for people with persistent low back pain and/or sciatica
Spinal injections are typically done when pain is not relieved by:

  • Rest
  • Ice and heat therapies
  • Medications
  • Physical therapy
  • Back exercises
  • Changes to the physical set-up of the work environment
  • Changes to physical activities, including work
  • Spinal manipulation
Possible Complications
Complications are rare, but no procedure is completely free of risk. If you are planning to have an injection, your doctor will review a list of possible complications, which may include:

  • Headache
  • Allergic reaction to the medication
  • Bleeding
  • Infection
  • Nerve damage
  • Fainting
Some factors that may increase the risk of complications include:

  • Current infection
  • Certain pre-existing medical conditions
  • Treatment with blood thinners or certain other medications
  • Poor health
What to Expect
Prior to Procedure
You may have the following done before the procedure:

  • A brief physical exam
  • Imaging studies to look for the location of possible causes of the pain, including
Talk to your doctor about your medications. You may be asked to stop taking some medications up to one week before the procedure, like:

  • Anti-inflammatory medications
  • Blood thinners
Anesthesia
A local anesthetic and/or a sedative may be used. They may help to reduce pain and anxiety . You will be awake for the procedure.

Description of the Procedure
You will lie on your side on an x-ray table. The skin on your back will be washed with a sterile solution. A syringe containing corticosteroid medication and a local anesthetic will be injected through the skin and into a space near the spine. X-ray imaging will be used to guide the placement of the needle. Contrast material may also be injected to confirm that the needle is in the right place. The medication will be injected and the needle will be removed from your back. A small bandage may then be placed over the injection site.

Corticosteroid Injection

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How Long Will It Take?
The procedure will take less than one hour. The entire visit takes about 2-3 hours.

Will It Hurt?
The injection of the local anesthetic may burn or sting for a few seconds. After that, you should not feel pain during the procedure.

Post-procedure Care
At the Care Center
  • You will spend time in a recovery area where your recovery will be monitored.
  • Because you were sedated during the procedure, you will need someone to drive you home.
  • Potential temporary side effects include:
    • Brief period of increased pain
    • Headaches
    • Trouble sleeping
    • Facial flushing
    • Hiccups
    • Lightheadedness from low blood pressure
At Home
When you return home after the procedure, do the following to help ensure a smooth recovery:

  • Rest on the day of the procedure.
  • Apply ice packs for soreness at the injection site.
  • Ask your doctor about when it is safe to shower, bathe, or soak in water.
  • Be sure to follow your doctor's instructions .
It will take a few days to a week for the medication to reduce the inflammation and pain. You should be able to resume your regular activities the day after the procedure. You should be able to start exercising within one week.

Call Your Doctor
After arriving home, contact your doctor if any of the following occurs:

  • Signs of infection, including fever and chills
  • Redness, swelling, increasing pain, bleeding, or discharge from the injection site
  • Shortness of breath or chest pain
  • Numbness, tingling, pain, or weakness, especially in the arms, hands, legs, or feet
  • Changes in urine or bowel function
  • Sudden increase in weight of more than five pounds
In case of an emergency, call for medical help right away.




RESOURCES:
American Academy of Orthopaedic Surgeons

American Association of Neurological Surgeons

CANADIAN RESOURCES:
Canadian Orthopaedic Foundation


References:
Epidural steroid injections. KnowYourBack website. Available at: http://www.knowyourback.org/Pages/Treatments/InjectionTreatments/ES_Injections.aspx. Published July 17, 2009. Accessed November 25, 2013.

Lumbar epidural steroid injections. Beverly Pain Management website. Available at: http://www.pain-clinic.org/lumbarepiduralsteroidinjections. Accessed November 25, 2013.

Manchikanti L, Staats PS, Singh V, et al. Evidence-based practice guidelines for interventional techniques in the management of chronic spinal pain. Pain Phys. 2003;6:3-81.

Last Reviewed November 2013



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