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Spinal Corticosteroid Injection

(Spinal Steroid Injection; Epidural Steroid Injection)

Definition

A spinal corticosteroid injection puts steroid medicine in the epidural space around the spinal cord.

Reasons for Procedure

The procedure is done to:
  • Ease pain and swelling around the spine and nerve roots
  • Improve function for people with back pain, such as low back pain with sciatica

Possible Complications

Problems are rare, but all procedures have some risk. The doctor will go over some problems that could happen, such as:
  • Excess bleeding at the injection site
  • Allergic reaction to the medicine used
  • Infection
  • Nerve injury
Things that may raise the risk of problems are:
  • Current infection
  • The use of blood thinners
  • Chronic diseases, such as diabetes or obesity

What to Expect

Prior to Procedure

The care team may meet with you to talk about:
  • Anesthesia options
  • Any allergies you may have
  • Current medicines, herbs, and supplements that you take and whether you need to stop taking them before the procedure
  • Whether you need a ride to and from the procedure
  • Tests that will need to be done before the procedure, such as images of the spine

Anesthesia

The doctor may give local anesthesia. The area will be numbed

Description of the Procedure

You will lie on your side on an x-ray table. The doctor may inject a contrast dye. X-ray imaging will be used to guide the placement of the needle in the epidural space. The medicine will be injected. The needle will be removed. A small bandage may be placed over the site.
Corticosteroid Injection
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How Long Will It Take?

About an 1 hour

Will It Hurt?

Pain is common at the injection site. It may last several hours. Medicine and home care can help.

Post-procedure Care

At Home
It will take a few hours for the injection site discomfort to go away. It will take a few days to a week for the medicine to ease pain and swelling. You should be able to go back to regular activities the day after the procedure.

Call Your Doctor If Any of the Following Occur

Call the doctor if you are not getting better or you have:
  • Signs of infection, such as fever and chills
  • Redness, swelling, increasing pain, bleeding, or discharge from the injection site
  • Pain that you cannot control with medicine
  • Nausea or vomiting
  • Sudden increase in weight of more than 5 pounds
  • Shortness of breath, or chest pain
  • Numbness, tingling, pain, or weakness in the arms, hands, legs, or feet
  • Headache that worsens when you sit or stand and gets better when you lie down
  • Loss of bladder or bowel control
If you think you have an emergency, call for medical help right away.

RESOURCES

Know Your Back—North American Spine Society
https://www.knowyourback.org
Ortho Info—American Academy of Orthopaedic Surgeons
https://www.orthoinfo.org

CANADIAN RESOURCES

Canadian Orthopaedic Association
http://coa-aco.org
When it Hurts to Move—Canadian Orthopaedic Foundation
http://whenithurtstomove.org

References

Epidural steroid injection. EBSCO DynaMed website. Available at: https://www.dynamed.com/procedure/epidural-steroid-injection . Accessed September 30, 2020.
Epidural steroid injections. Know Your Back—North American Spine Society website. Available at: https://www.spine.org/KnowYourBack/Treatments/InjectionTreatmentsforSpinalPain/EpiduralSteroidInjections.aspx. Accessed September 30, 2020.
Goertz M, Thorson D, et al; Institute for Clinical Systems Improvement (ICSI). Adult acute and subacute low back pain. ICSI 2012 Nov.
Spine injection. Massachusetts General Hospital website. Available at: http://www.massgeneral.org/imaging/services/procedure.aspx?id=2268. Accessed September 30, 2020.

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