Cervical Epidural Injection
What is the epidural space?
The covering over the nerve roots in the spine is called the dura.
The space surrounding this dura is the epidural space. Nerves travel
through the epidural space before they travel down into your arms. The
nerves leave the spine from small nerve holes. Inflammation of these
nerve roots may cause pain in your neck, shoulder or arms. These nerve
roots may become inflamed due to irritation from a damaged disc or from
contact with bone spurs.
What is an epidural injection and why is it helpful?
An epidural injection places anti-inflammatory medicine into the epidural
space to stop inflammation of the nerve roots, therefore hopefully reducing
the pain in the neck, shoulders, and arms. By stopping or limiting nerve
root inflammation we may be able to reduce your pain. The epidural injection
may assist the injury to heal by reducing inflammation. Although not
always helpful it usually reduces pain and improves function in the
majority of cases within 3-7 days. It may provide permanent relief or
provide a period of pain relief that will allow other treatments like
physical therapy to be more effective. We hope it will reduce your pain
during the next several months while the injury/cause of your pain is
healing.
What will happen to me during the procedure?
First an IV is started so that you may be given medicine for relaxation
if you so desire. Next, while lying face down on a x-ray table your
skin will be well cleaned. The physician will numb a small area of skin
in the back of your neck which may sting for a few seconds. Next, the
physician will use x-ray guidance to direct a small needle into the
epidural space. There will be pressure felt with this part of the procedure.
He will then inject contrast dye to confirm that the medicine spreads
to the affected nerve root(s) in the epidural space. After this, the
physician will inject a combination of numbing medicine and time release
anti-inflammatory cortisone.
What should I do after the procedure?
You will wait 30-60 minutes in recovery before going home. You should
not drive for eight hours following this procedure. Please record your
pain relief during the next week on a "pain diary" we will provide to
you. Mail the completed pain diary back Tyler Neurological Associates.
If you experience complete relief, or more than 90% relief, of your
pain we will not repeat the procedure. If you experience partial relief
it may be beneficial to repeat the procedure in about two weeks. If
you experience no relief, notify the office and the procedure will probably
not be repeated. We perform a maximum of three epidurals each 2 weeks
apart.
General Pre/Post Instructions
You should eat a light, but not a full meal at least 2 hours before
the procedure. If you are an insulin dependent diabetic do not alter
your normal food intake. Take your routine medications before the procedure
(such as high blood pressure and diabetes medications). Stop aspirin
and all anti-inflammatory medications (e.g. Motrin/Ibuprofen, Aleve,
Relafen, Daypro) 3 days before the procedure. These medicines may be
re-started the day after the procedure. You may take your regular pain
medicine as needed before/after the procedure. If you are on coumadin,
heparin, lovenex, plavix or ticlid you must notify our office so that
the timing of stopping these medications can be explained. If you are
on antibiotics please notify our office, we may wait to do the procedure.
If you have an active infection or fever we will not do the procedure.
You will be in the hospital as an out-patient for 2-3 hours even though
you see the physician for 20 minutes. You will need to bring a driver
with you. You may return to your current level of activities the next
day including return to work.
|
