What you need to know about:

Epidural Steroid Injection

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Average Cost:
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Recovery Period:
Several days
Permanence:
Depends on patient condition
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Time it takes:
within 1 hour
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Anesthetize:
General Anesthesia

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Overview of

Epidural Steroid Injection

in Thailand

Epidural steroid injection involves the administration of corticosteroid and anesthetic into the epidural space or close to the area of pain to treat pain caused by irritation and inflammation of spinal nerve roots.

Goals of

Epidural Steroid Injection

Epidural steroid injection is performed to help relieve pain and swelling in and around the spinal nerve roots without surgery, and find the specific location in the spine in which the pain originates. (If you have pain relief after the injection, this means the pain is originated from this area. If you do not have any pain relief after the injection, the cause of the pain is likely from different part of the spine or other cause than inflammation.)

Price of

Epidural Steroid Injection

Average Cost

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Price Range

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Pros and cons of

Epidural Steroid Injection

Pros

Reduce nerve pain and inflammation. Steroids decrease the production of inflammatory chemicals and reduce the sensitivity of nerve fibers to pain, generating fewer pain signals.   Limit oral medication. Pain relief from these injections may help limit or eliminate the need for oral medications,4 some of which may have side effects when taken long-term.   Continue or re-engage in physical therapy. This injection may provide sufficient pain relief to allow a patient to progress with a rehabilitative physical therapy program.   Postpone surgery. Pain relief experienced from lumbar epidural steroid injections may help postpone surgery, and if physical therapy is effective, it may eliminate the need for surgical intervention.

Cons

Temporary side effects may occur in some cases and include (but are not limited to):  Post-injection pain  Nausea  Headache  Dizziness  Fainting (vasovagal attack)  Flushing of the face

How it works:

Epidural Steroid Injection

Your doctor will use an X-ray with a special dye to insert the needle in the right spot. They will choose a location along your spine from the bottom of your neck to your tailbone that is closest to the nerve causing your pain. The procedure can take as little as 15 minutes and the numbing part of the shot may start to work fairly quickly. (The steroid part, which lasts longer, should start to work in 2 to 5 days.) Doctors may also use epidural injections to find the source of your pain. In this case, the injection will target a specific nerve. If it helps your pain, your doctor will know they've found the right nerve.

Preparation before

Epidural Steroid Injection

Pre - treatment

Prior to your procedure, your blood may be tested to determine whether it clots normally. Tell your doctor about all the medications you are taking, including herbal supplements, and whether you have any allergies, especially to local anesthetic, general anesthesia or contrast materials containing iodine. Your physician may advise you to stop taking aspirin, nonsteroidal anti-inflammatory drugs (NSAIDs) or blood thinners for a specified period of time before your procedure. Tell your doctor if you are taking blood-thinning medications such as Warfarin (Coumadin), Heparin, Lovenox, clopidogrel (Plavix) and over-the-counter pain relievers such as aspirin, ibuprofen or naproxen. Talk to your doctor about any recent illnesses or other medical conditions. Metal objects, including jewelry, eyeglasses, dentures and hairpins, may affect the CT images and should be left at home or removed prior to your exam. You may also be asked to remove hearing aids and removable dental work. Women will be asked to remove bras containing metal underwire. You may be asked to remove any piercings, if possible. You will be asked not to eat or drink anything for a few hours beforehand, as contrast material may be used in your exam. You should inform your physician of all medications you are taking and if you have any allergies. If you have a known allergy to contrast material, or "dye," your doctor may prescribe medications (usually a steroid) to reduce the risk of an allergic reaction. These medications generally need to be taken 12 hours prior to administration of contrast material. To avoid unnecessary delays, contact your doctor before the exact time of your exam You will be given a gown to wear during the procedure. Women should always inform their physician and technologist if there is any possibility they may be pregnant

Recovery after

Epidural Steroid Injection

Post - treatment

You may feel sore at the area of the needle insertion for a few days. You may apply ice or a cold pack to the injection site and your doctor may prescribe pain relief medication if you have significant pain. You should avoid strenuous activities and driving for 24 hours. You may feel your pain level increase as the numbing medicine wears off and before the cortisone begins to take effect. Rarely, you may experience side effects from the anti-inflammatory medication

Risks & side effects

Epidural steroid injections are considered a relatively safe and minimally invasive. Temporary side effects may occur in some cases and include (but are not limited to): -Post-injection pain -Nausea -Headache -Dizziness -Fainting (vasovagal attack) -Flushing of the face These side effects typically resolve in a few minutes to hours. Serious complications, while rare, may include spinal cord damage, dural puncture, and/or stroke.

FAQs:

Epidural Steroid Injection

Who shouldn't get epidural steroid injection?

Anesthesia drug allergies Blood clotting problems An infection Uncontrolled diabetes Some other medications you're taking

When are Epidural Steroid Injections indicated?

Lumbar epidural injections are typically used in the treatment of conditions that cause irritation and/or inflammation of spinal nerve roots with associated lower back and leg pain. Most common lower back conditions treated include:  -Lumbar Herniated disc(s) -Lumbar Degenerative disc disease -Lumbar Spinal stenosis  Less commonly, localized back pain (axial back pain) and neurogenic claudication (back pain and leg pain that occurs while walking) may be treated with these injections.

How often can you get epidural steroid injections?

Epidural steroid injections are recommended to be administered up to three to six times per year. In the case of a new disc herniation, injections may be only weeks apart with a goal of quick and complete resolution of symptoms. For chronic conditions, three to six months or more between injections is common.

Is any anesthesia used? Are epidural steroid injections painful?

A local anesthetic is injected into the skin, numbing the area where the epidural needle is then placed. Patients may experience mild discomfort but should not experience severe pain during the procedure.

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