Epidural injections & Root blocks

An injection of steroid mixed with local anaesthetic

Things you should know

Q. What is an epidural injection?
This is an injection of steroid mixed with local anaesthetic

Q. Who gives this injection? Is it a painful procedure?
Pain management specialists and anaesthetists give these injections. Local anaesthesia is given to numb the area and nowadays very thin needles are used which cause minimal discomfort

Q. When do I require the injection?
• When you are not a candidate for surgery or you do not want surgery
• When you have low back pain along with pain in the leg
• If you are not responding to medication and physiotherapy – it is advisable to take an epidural injection.

Q. Are they any side effects of steroids?
The steroid injection that is given is a local preparation it does not spread to rest of the body and it gets absorbed slowly. Unlike the oral steroids which may cause harm in the long term, the local steroid injection does not cause any harm to you.

Q. How safe is the procedure?
The procedure is very safe and one need not worry too much about the complications from the procedure which are extremely rare.

Q. How effective are these injections?
These injections work in only 50% of patients and in the other 50%, they do not work. Their effect lasts from 6 weeks to 6months

Q. How do these injections work?
This injection works by relieving pain and reduces the inflammation.

Q. What are the complications that can occur?
Injuries to the nerve tissue and infections are some of the known complications of this procedure but these are extremely rare and uncommon. Infections are rare: occurs in 0.1 to 0.01 % of injections all over the world. Injury to nerve tissue is also extremely rare.
Sometimes puncture in the layers of the spinal cord can lead to leakage of fluid. This may cause head ache for a few days. Drink plenty of fluids and it will usually subside.

Q.What are the preparations required for the procedure?
Your sugar and blood pressure should be under control and you should not be taking anticoagulants (blood thinners) including aspirin. If you are on these medications you should consult your cardiologist/physician and stop these medications5 days before you undergo the procedure.
You are requested to consult the anaesthetist/physician /pain specialist with all your reports including x-rays and scans before the procedure.

Q. When do I get admitted to the hospital?
You get admitted on the day of the injection.

Q.Do I need to fast before the procedure?
You are requested not to eat any solids or liquids 2 to 3 hours before the procedure. A light breakfast is quite ok 2 to 3 hours before the procedure

Q.How long I need to stay in the hospital?
For about 3 hours after the procedure.

Q.What are the precautions that I need to take when I go home?
You may feel slight weakness or numbness in the legs because of the medication that is injected. This usually reduces over a period of time. If you go home, take a few seconds before you get up and few seconds to sit or stand and only then go to the washroom. Do not bolt the door of the washroom because if you need help your attendants cannot come inside. From the next day onwards you can get back to work.

Q. How often do I need to take injections?
There is no definite course. You need to take injections either once in 10 to 15days or once a month.

Q. How often can I repeat these injections?
You cannot take more than 3 injections in one year.

Q. Do I need physiotherapy and when do I come back to see the doctor?
A set of medications and instructions for physiotherapy will be given to you at the time of discharge along with advice to come back for a review 2-3 weeks after the procedure.