Spinal Injections Relieve Arthritis Pain: Procedure Information

Procedure Preparation

Please refer to our pre-procedure instructions. We require you to sign a consent form before your injection procedure.

Our medical team will provide you with special pre-procedure information specific to you well in advance of your procedure date. This may include information about your regular medications.

If you take blood thinning medication such as Coumadin® or Plavix®, please notify our medical team. Certain drugs must be stopped several days before your procedure.

Please make advance arrangements for someone to drive you home the day of the procedure.

Possible Risks and Complications

The most significant problems associated with the epidural injections can be nerve damage, spinal cord damage, infection, allergic reaction, bleeding and hematoma formation in the spinal canal or headaches. Headaches are probably the most common of the above side effects. Hematoma formation can happen in one patient every 250,000 injections or so, which can be significant and may need surgical decompression to stop the bleeding and prevent paralysis.

In our practice, side effects have been minimal. Rarely have we seen patients react to the steroids. Some patients experience minor pain after the procedure. Since the injection contains a local anesthetic, pain may be immediately relieved; however, it can cause the leg to feel heavy.

What to Expect: The Procedure and After

The environment and preparation is similar to any outpatient procedure. You are brought into a recovery area where you change into a hospital gown and rest in a recliner. If you desire, medications to relax you are given intravenously (IV). You are moved into the procedure suite. There, you are positioned face down with a cushion beneath your abdomen to flex the spine and keep you comfortable. Once in the procedure room, if you requested anesthesia, the anesthesiologist administers the sedation. The anesthesia or twilight is similar to that used during a colonoscopy. Next, the skin area is cleansed using sterile soap.

Using fluoroscopy (real time x-ray), the physician inserts a small needle into the target location and injects a small amount of contrast (dye) to confirm proper position. Next, an anesthetic and corticosteroid is injected into the target location within the epidural space. The needle is then removed. A small band-aid may be used to cover the injection site; however the needle is so small that you often do not need a bandage.

Depending on the number of spinal levels injected, the entire procedure is over in about 10 minutes. Afterward, you are moved into the recovery area and monitored until our medical team deems you ready for release. The twilight wears off quickly and you may experience a minimal hangover. Our medical team is dedicated to making you as comfortable as possible.

Before you are released home, our medical team provides you with written home care instructions. It is possible that you may experience minor discomfort after the procedure. This is normal and does not necessarily mean the corticosteroid is not taking effect. It can take up to 48-72 hours for the onset of the steroid.

After the Procedure

We want you to keep a log of your pain. Again, the procedure involves blocking the nerve to the facet joint, so it is important to know how you feel for the first day after the procedure. During this time, the local anesthetic effect is taking place.

If the local anesthetic blocks the nerve that is transmitting your pain, your pain should improve. This information is important because if you have a positive response to the local anesthetic then you will likely respond to a radiofrequency procedure, which may provide you 6-9 months of pain relief.

If used, a steroid can lengthen duration of pain relief — possibly weeks to months.

Contact Us

If you experience unusual symptoms or symptoms that persist, please contact Spine and Pain Consultants at (718) 667-3577 or (212) 724-7246.

For after hour emergencies, please call our answering service at (718) 667-3577, or proceed to the nearest emergency room for after-hours emergencies.