Epidural Injections

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An epidural injection delivers powerful anti-inflammatory medicine into the epidural space located outside of the sac of fluid around the spinal cord. Two types of epidural injections are interlaminar injections and transforaminal injections.


Interlaminar Epidural Injections


Interlaminar injections are done to help reduce pain in the lower back, leg, neck, or arm caused by sciatica, herniated discs, misaligned vertebrae, or other back problems. An interlaminar injection may be an appropriate treatment for patients who have had pain for more than four weeks.

Patients may experience pain relief 30 minutes after this type of injection. However, pain may return a few hours later, once the anesthetic has worn off. Long-term pain relief begins two to three days after the injection.

The long-term effects of the injection will vary. Some patients may experience pain relief that lasts several months or longer.

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Transforaminal Epidural Injections


A transforaminal injection can help relieve pain in the lower back, legs, and feet caused by sciatica, herniated discs, or other back problems. The injection site is in the area between the spine and spinal cord.


Before The Procedure


Patients may need to temporarily stop taking blood thinners, including aspirin, ibuprofen, clopidogrel, warfarin, naproxen, and heparin.

What to Expect During The Procedure


The patient will change into a hospital gown and lie face down on an X-ray table with a pillow under their stomach. The physician will cleanse the injection site and numb the area. Patients may be given medicine to help them relax.

Under X-ray guidance, the physician will insert a needle into the patient’s back and inject a mixture of steroid and numbing medicine into the area. The medicine will decrease swelling and pressure on the larger nerves around the spine and help relieve pain. The numbing medicine can also help the physician identify the painful nerve.

Patients may feel some pressure during the injection but shouldn’t experience any pain. It is important for patients to be extremely still during the procedure because the injection needs to be very precise. The entire procedure takes 20 minutes.

Patients will be monitored for 15 to 20 minutes after the injection before being discharged.

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After The Procedure


Patients may feel some temporary discomfort in the injection site and should rest for the rest of the day. After the procedure, patients can continue their regular diet and resume taking their medication, but should avoid driving or engaging in rigorous activities for 24 hours.

Pain may worsen for two to three days after the procedure before they experience pain relief. The injection typically takes two to three days after the injection to work.

Potential Risks


An epidural injection may lead to the following side effects:

  • Mild dizziness, headache, or nausea
  • Nerve root damage with increased pain down the leg
  • Infection in or around the spine (meningitis or abscess)
  • Allergic reaction to the medicine used
  • Difficulty breathing if the injection is in the neck
  • Bleeding around the spinal column (hematoma)
  • Possible rare brain and nervous system problems

Patients should speak to their physician to find out if they are a good candidate for epidural injections.

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