The epidural space is the space between the lining of the spinal cord and the spinal column. The nerves leave the spinal cord and pass through the epidural space as they exit the spinal column to the body.
Spinal nerves become inflamed due to irritation from a degenerative, bulging, herniated or damaged disc. Degenerative joint changes or contact with a bone spur may also irritate the nerve. Depending on which part of the spine the inflamed nerves are located in, pain and/or other symptoms (such as numbness or tingling) may be experienced in different areas of the body.
- Cervical: symptoms may include neck pain, muscle spasms, as well as pain, numbness and tingling that travels down into the arm.
- Thoracic: back pain that can run to the ribs and to the chest wall
- Lumbar: symptoms may include back, hip and buttock pain as well as pain, numbness and tingling down into the leg
This procedure is the placement of an anesthetic and anti-inflammatory (steroid) solution in the epidural space where the disc and nerves are located. The purpose of this injection is to decrease the inflammation and irritation around the disc and nerve roots before they exit the spine, thereby reducing your pain. The procedure may be repeated periodically, if necessary, and is an important part of treating conditions such as herniated discs, sciatic pain, spinal stenosis and degenerative disc disease. It can be performed in the cervical, thoracic or lumbar regions. All procedures are done under fluoroscopic guidance (X-ray-guided) to ensure proper placement of the medication and may be performed in an ambulatory surgical center, fluoroscopy suite or hospital setting.
The procedure usually takes about 30 minutes. There may be an increase in discomfort the first two to three days following the procedure when the numbing medication wears off. The full therapeutic effect and pain relief from the epidural injection may take up ten days after the injection. One of the goals of the epidural injection is to reduce the inflammation at the site of the problem and provide enough pain relief to allow the patient to progress with their rehabilitation program.