Epidural Injections in Valencia, CA and Lancaster, CA

There are several types of epidural steroid injections depending upon the location the injections are placed. Cervical epidural steroid injections are injections placed in the neck. Injections in the middle of the back are known as thoracic epidural injections. Injections placed in the lumbar spine are called lumbar epidural injections. Some epidural injections are placed into the space that surrounds the spinal cord or interlaminar area. The lamina is the portion of the vertebra that lies on top of the adjacent vertebra like a shingle on a roof and surrounds the spinal column. Steroid injections placed into the epidural space at this area between two adjacent laminae are called inter-laminal or translaminar epidural steroid injections (TLESI). Another type of injection is placed into the area that branches off the spinal column at the nerve root which is called transforaminal epidural steroid injections (TFESI). 

Most ESI procedures are performed at an outpatient surgical center. Twilight or conscious sedation is often used to perform an ESI.  This sedation technique provides short-term mild sedation using a combination of intravenous medications.  Patients are placed on their stomach with a pillow underneath. The physician will use X-ray guidance with Fluoroscopy to verify the desired level for injection.   Using mild sedation and X-ray guidance helps allow for precise application of the injection.  After cleaning the desired area of the back the physician injects the mixture of steroid and anesthetic medication into the area.  The steroid medication decreases the swelling and pressure caused by inflammation. The numbing medication can also be used to identify a painful nerve or level in the spine that is causing the pain. The procedure actually only takes a few minutes, but the patient is monitored by surgical staff for 30-60 minutes after awaking from sedation. 

After an epidural steroid injection:

• Rest for the remainder of the day

• Resume eating or drinking 

• Avoid driving or operating machinery for 24 hours

• One may experience some numbness, tingling or weakness in the legs that usually resolves within 24-48 hours

Epidural steroid injections are generally safe. Some of the potential complications include:

• Headache (if the needle goes too deep and punctures the tissue that surrounds the spinal cord and nerve root, known as the dura, causing spinal fluid to leak)

• Allergic reaction to one of the medications or anesthetic medications

• Nerve injury (if the needle touches the spinal cord or nerve root)

• Increase potential for infection 

• Bleeding from injection site

• Repeated use of steroids can weaken vertebrae contributing to osteoporosis

• Repeated use of steroids can weaken nearby muscles, tendons, and ligaments

Epidural steroid injections are often utilized as a treatment option used alone or in conjunction with other pharmacological or non-pharmacological treatments for pain management. Some of the benefits include but is not limited to:

• Decrease pain by breaking the cycle of inflammation

• Decrease pain with the local anesthetic blocking pain signals in the nerves

• Decrease in symptoms of weakness or tingling 

• Diagnostic purposes: used prior to surgery to help identify the level in the spine causing the symptoms

• Pain relief treatment for when surgery is not an option

• Help decrease symptoms to allow for more functionality (e.g. as an adjunct to therapy)