INJECTION FOR YOUR BACK & NECK

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Bathsheba Eileen Hubbard
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1 INJECTION FOR YOUR BACK & NECK CERVICAL EPIDURAL CERVICAL FACET BLOCKS LUMBAR EPIDURAL FACET BLOCKS ROOT BLOCKS

2 INJECTIONS FOR YOUR BACK A lumbar caudal epidural steroid injection is an outpatient procedure for treating low back and leg pain. Facet & root blocks are injection into a specific joints of spine and along the nerve roots as required. Introduction : In a lumbar epidural injection, an anti-inflammatory medicine is injected into the epidural space to reduce inflammation. A local anesthetic (numbing medicine) may also be injected. When the injection is done through the bony opening in your tailbone then this is called a caudal epidural injection. An injection in a joint of the back is called a facet joint injection. An injection along the nerve root sleeve is called a root block. Getting Ready for Treatment : Provide a list of all medicines you take, including aspirin and anti-inflammatory drugs. Don't eat 6 hours before the injection but you can have a light drink 4 hours before injection. Arrange for a responsible adult to drive you home after the procedure. Bring all X-ray & MRI images on the day of the procedure You need to stop blood thinning drugs like asprin, clopidogriel etc. 5-7 days before the injection. But consult your cardiologist before hand.

3 During the procedure: The injection takes just a few minutes. But extra time is needed to get ready. A local anesthetic will be used to numb your skin. The doctor will then insert a thin needle directly into the epidural space. A type of X-ray or C-arm may be used to ensure the safe and proper position of the needle. Contrast "dye" may be injected into your back, this helps get a better image. Once the doctor is sure the needle is correctly placed the medicine will be injected. After the procedure: 1. You will be monitored for up to 30 minutes after the injection. You will spend up to an hour in a recovery area. 2. When you are ready to leave the staff or nurse will give you discharge instructions. 3. Before going home you may be asked to fill out another survey about your pain, because it helps your doctor know how the injection is working. 4. You may feel immediate pain relief and numbness in your back and leg for a period of time after the injection. This may indicate that the medication has reached the right spot. 5. Your pain may return after the short pain free period, or may even be a little worse for a day or two. It may be caused by needle irritation or by the corticosteroid itself. 6. You can usually return to work the day after the injection but always check with your doctor.

4 How long can I expect pain relief? The extent and duration of pain relief may depend on the amount of disc, dural or nerve root inflammation Sometimes an injection brings several weeks to months of pain relief and then further treatment is needed Other times a single injection brings long term pain relief Risks and Complications: An epidural injection has certain risks and complications : 1. Spinal headache 2. Bleeding (rare) 3. Infection (rare) After the procedure you may notice some side effects : These should go away in the first few days 1. Briefly increased pain 2. Headaches When you get home in the first few days : 1. Take walks when you feel up to it 2. Rest if needed, but get up and move around after sitting for half an hour 3. Don't exercise vigorously 4. Don't drive the day of the procedure wait till your doctor says it's ok

5 Call your doctor immediately if you notice any of the following symptoms 1. Severe pain or headache 2. Fever or chills 3. Loss of bladder or bowel control 4. Redness or swelling around the injection site We wish you a safe recovery.

6 This booklet has been published for public distribution by Dr. Shankar Acharya (Orthopaedics and Spine Surgeon) Trustee KOST-Kadambini Charitable Trust (Regd. No. DL-P ) SPINE HELPLINE Rakesh : Sandeep :

Lumbar Epidural Injections. Treatment to Reduce Pain

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