At Maine Medical Partners Neurosurgery & Spine, we offer a multispecialty approach to conservative treatments of spine conditions and provide comprehensive evaluation and treatment of spine and musculoskeletal disorders. Our team of highly trained physiatrists, osteopaths, physician extenders, physical therapists and nurses work together to offer alternative treatment options to patients, whenever appropriate.
These are injections of corticosteroids (cortisone medicine) into the space just outside the dura, which lines the spinal canal, and surrounds the spinal cord and nerves. Because the injection is outside the dura, it is called an epidural injection. This procedure has nothing to do with spinal anesthesia used for operations. Epidural injections may be done for pain relief or to confirm a diagnosis. The injections are also sometimes done near or into a joint in the back if that area is thought to be painful.
These injections are performed when it is thought that inflammation and/or swelling is part of the process that causes the pain. A steroid medicine, which is a very potent anti-inflammatory drug, works best when it is injected into the area where the inflammation is occurring. Because the nerves coming off of the spinal cord pass through the epidural space, the medicine comes in contact with them. The injections can be made anywhere along the spine: neck (cervical), midback (thoracic), lower back (lumbar) and tailbone (caudal). Injections can also relieve inflammation around a joint (facet injection). The steroid is usually combined with a local anesthetic to reduce discomfort and to aid in diagnosis.
Often, more than one injection is required.
You will be re-examined by the provider doing the procedure. The procedure will be explained to you and a consent will be obtained. You may be asked to change into an examination gown. You will go into the x-ray room and lay or sit on the table. You could be on your side, stomach or sitting depending on the type of injection. Iodine will be applied to your skin to keep the area sterile. The doctor will numb the skin of the injection site and then a needle will be inserted under x-ray visualization into the area to be injected. You may be asked if what the doctor is doing increases or decreases your pain. The medication will then be injected slowly. This procedure takes 15-20 minutes.
After the procedure you will be taken to the recovery area for monitoring by the nurse. You will be offered a snack and asked to describe any changes in your pain. You will be monitored for at least 20 minutes before going home.
Complications from injections are rare, but, as with any procedure, there could be problems. This can include the following:
A discogram is a test that is done in order to view the makeup of a disc and to make clear whether that disc may contribute to your pain. It will allow your doctor to see tears in the disc, scarring, disc bulges and changes in the center of your disc.
A needle will be inserted in a vein (IV) so the antibiotics may be given prior to this procedure. Relaxants and pain medications will be given during the procedure. A local painkiller will be injected into the skin over the area(s) that will be examined. An x-ray machine will be used to view proper placement of a needle into the disc. Dye will be injected into the disc or discs being examined and the disc will be pressurized for evaluation. Risks of the procedure will be fully explained prior to the procedure. The procedure may take 30-60 minutes, and you will be asked to wait up to 30-60 minutes longer until you are recovered before going home.
“The people of Maine are motivated, appreciative and often profoundly inspiring as they confront the many challenges associated with neurological disease.”
John B. Wahlig, MD, Neurosurgeon