When you have pain and inflammation caused by a herniated disk, sciatica, or spinal stenosis, your doctor can relieve your discomfort either with a selective nerve root block or epidural steroid injection.
An epidural steroid injection is a spinal procedure in which a steroid and usually an anesthetic is injected into the spinal region called the epidural space. In this area, the nerves, spinal fluid, and spinal cord are enclosed within a membrane sack called the dura. The injection, administered outside this membrane, is useful in reducing inflammation from nerve roots or intervertebral discs. Decreasing the inflammation may decrease the pain you’re experiencing, and give the body a chance for activity and proper healing.
There are different types of epidural steroid injections:
· A caudal injection is placed through a small opening called the sacral canal just above the tail bone.
· With an interlaminar injection, the needle is usually midline and placed directly between two vertebrae. Contrast dye is injected to confirm proper needle position.
· A transforaminal injection is placed in the opening on the side of the spine near the exiting nerve.
A selective nerve root block, on the other hand, is a spinal procedure in which anesthetic is placed on a specific nerve root of the spine to help identify the exact source of your pain.
Usually, the injection also contains steroid to decrease inflammation and pain. It’s similar to a transforaminal epidural steroid injection, but in a selective nerve root block there is no attempt to have the medication enter the epidural space. Instead, the aim is strictly to cover the offending nerve root.
A Quick, Relatively Painless Procedure
Both types of injections are usually done while the patient is lying on his or her stomach under fluoroscopic X-ray. The skin is cleaned thoroughly with antiseptic solution before the injection is performed. After the skin has been numbed with local anesthetic, a small spinal needle is inserted under fluoroscopic guidance to the appropriate position within the spine.
For selective nerve root blocks and the transforaminal approach for an epidural steroid injection, the final needle position is just above the target nerve root. The medication is then injected.
During the relatively painless procedure – which only takes about 15 to 30 minutes, the patient’s vital signs are closely monitored. After the treatment, the patient is taken to the post-procedure area for continued monitoring.
If anesthetic is placed around a nerve root or epidural space, the patient may experience a period of numbness in the affected area for three to eight hours. For this type of procedure, it is strongly recommended that you have someone provide transportation home. The steroid medication may begin working anywhere from six hours to three days after the injection. If you do not feel the results after three days, you should consult back with the clinic.
Some patients may experience a period of soreness one to two days after the injection which can be relieved with an application of ice. However, you should notice significant pain relief within one to five days. In fact, the day after the procedure you can resume normal activities as long as they aren’t uncomfortable.
Note: You should not undergo a selective nerve root block or epidural steroid injection if:
· You are prone to excessive bleeding or currently taking blood-thinning medication.
· Your back pain has been diagnosed as being the result of an infection or malignancy.
· There is any systemic bacterial infection or local skin infection near the injection site.
Don’t let a herniated disc, sciatica, or spinal stenosis leave you in constant discomfort or keep you from doing the things you love to do. Finding the right interventional pain management clinic in Oklahoma can make all the difference. To learn more about your pain relief options, call The Brooks Clinic at (405) 400-0877 or schedule an appointment online.
