Epidural Injection

Epidural Injection

You have been advised to have an epidural caudal injection. This is an injection of medicine around your spinal nerves. The medicine is a combination of local anesthetic and steroid medication. It may help by reducing the inflammation and swelling which may be the cause of your pain.

The injection will not stop all of your back and leg pain, but may help reduce it. It may reduce the pain down the leg. The effect is temporary, though some patients say it helped for a long time.

The procedure will be done in the office. You should plan on about 45 - 60 minutes at the office after which your friend or family may drive you home.

Getting ready:

Stop taking the anti-inflammatory medication [Aspirin, Motrin, ibuprofen, Naprosyn, sulindac, Lodine, etc.] a few days before the injection.
Don’t eat for about 6 hours before the procedure.
Make sure the x-rays; MRI scans etc. are at the office or with you for the injection.

The injection: This will take only a few minutes. You will be lying down, and the skin around the buttock area will be cleansed. A combination of local anesthetic, saline, and cortisone medication will be injected. You may need to stay in the office until you are felt to be stable.

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At home: You may have a rebound of pain for the first few days. Even if you feel quite well, avoid heavy activity for the first few days.

The first few days: It takes about a few days to 10 days to see significant results. Walk around the house or outside, as you feel comfortable. Avoid strenuous activity for the first few days. You may drive the next day after the injection.

Potential risks and complications of a lumbar caudal steroid injection

Procedures of any type have some potential risk. The possibility exists though the probability may be low. You should know that though improbable, the following things may happen:
Infection: This may occur to some extent whenever a needle is introduced into our bodies. Antibiotics may be needed. Surgery may be necessary if an abscess has to be evacuated.
Drug reactions: Unexpected allergic reaction, or illness caused by the drugs is a possibility. It is important that you inform Dr. Rao of any allergies you may have. You may have visual blurring. This may be a form of retinopathy. Please arrange to see your ophthalmologist right away.
Anesthetic reactions: There may be unusual or unexpected reaction to the medication or injected local anesthetic. This may lead to an emergency problem with your lung, heart or kidney function.
Post operative pain: You may experience pain after the procedure for which you will be prescribed medication.
Other risks: It is not possible to list every single risk to the procedure and the medications used. This also depends on your individual health. Please discuss any questions you may have with Dr.Rao.

Alternative treatments: Other ways of managing the problem may vary from doing nothing at this time; to taking different treatment measures may be considered depending on your personal situation. Do not hesitate to discuss the reasons for your choice and the alternative treatments available. The potential risks and side effects of each treatment should also be considered.

After the injection – discharge instructions:

	Go to the nearest emergency room should you have symptoms that concern you greatly.
	Contact your doctor immediately if you experience severe symptoms which you did not expect including:

	High fever over 100 degrees
	Severe headache especially when standing
	Worsening of any weakness
	Loss of control of bowel or bladder function
	Drainage from the injection site
	Change in mental status [confusion, loss of consciousness etc.]
	Others severe troubling symptoms.

You have received an injection of medication into your spine for relief of pain. You may feel soreness at the site of injection for a few days. Your original symptoms may even be slightly worse and for a day or two.
You may experience "hot flashes" at night. You may also experience some water retention or "puffiness" of your hands or legs. If you have diabetes or glucose intolerance, your blood sugar may vary considerably for a few days and should therefore be monitored closely until it stabilizes.
You may experience numbness around the area of your usual pain for several hours. Be very cautious about injury to the "numb" portion of your body. You may also experience weakness of your legs. Be very careful when walking until this feeling resolves.
If you experience a headache with the injection rest with your head flat and drink lots of fluids.
Rest today. Resume moderate activity and walking at home. Avoid long periods of sitting, heavy lifting, bending or any activity that causes you pain regardless of how well you feel. Gradually resume your normal activity, as you feel able to do so.
Be aware that your legs may feel weaker today but this feeling will resolve. We suggest that a responsible adult be with you for the rest of the day and through the night for your safety.
You may use ice for 30 minutes at a time every hour for the first day to relieve discomfort at your injection site. Place the ice on a towel over your skin. Tomorrow you may alternate heat and ice.
Take your regular medication as prescribed.
The injection should start to give you some noticeable reduction in your pain over the next 7-10 days. Discuss your changes if any with Dr.Rao at your next follow up visit.

Best wishes for your good health!!