Epidural Injections: When and Why Are They Given

An epidural injection is a kind of local anesthesia that gives non-permanent, long-lasting relaxation from pain or swelling in the spine or limb (arms and legs). The needle is inserted in a proper position to provide possible relief to the sufferer.

Generally, the doctor asks you some crucial questions about your medical routine and briefs you on the procedure. Some precautions are also advised, like fasting for several hours before the process. During the procedure, wearing jewelry is not permitted; loose clothes are recommended, perhaps a gown or something comfortable. You are also advised to not drive a car post-epidural.

About the procedure

The primary purpose of an epidural injection is pain management either during, say, vascular surgery or for knee pain relief. This injection is generally administered to a patient on a live X-ray table. It may continue for almost half an hour. The doctor may use a transforaminal (through the openings, especially in a bone via which nerve roots exit the spine), interlaminar (administered between two laminae, as of the vertebra), or a caudal course of dispensing the injection.

Why is an epidural injection given?

It is a pain management process, used by surgeons, dentists, or other doctors before any operation. It is used for relieving the pain for which the following, among other conditions, may be responsible:

• A body part affected by a hernia or outwardly swelling disk that hits nerves resulting in pain
• Minor widening of the spaces between the spines called spinal stenosis
• Long-standing leg pain or backache post spinal surgery
• Wounds or bruises to the spinal afferent, backbone, and other tissues
• Osteophytes (a bony growth that develops on the edge of a bone)

When is an epidural injection given?

Doctors have to find the origin of pain in the body by injecting it into a particular nerve during vascular surgeries. If it gives you some relief, your physician will take it as the right nerve. Apart from this, an epidural injection is used for treating severe conditions like nerve encroachment, spinal pain emission, a disk that is herniated, and osteophytes.

What is the stepwise epidural injection procedure?

The injection procedure involves steps which are as follows:

Step 1: The point where the injection is to be inserted is highlighted and disinfected using betadine.

Step 2: A live X-ray is taken with assistance to find the exact vertebral point for needle guidance.

Step 3: After getting live images on screen, a local anesthetic is dispensed to desensitize the targeted area.

Step 4: It is injected into the targeted area and guided with the help of fluoroscopy,= or live X-ray.

Step 5: A different pigment is inserted into the space between the membrane and the vertebra, known as epidural space, to verify the layout of the inserted material.

Step 6: Once the spread is verified, the steroid medication is inserted in the epidural space gap area.

What are the benefits of epidural injections?

• Non-permanent, lasting relaxation from pain
• Decrease in swelling in the spinal area that causes pain
• Locating the emerging point of pain, especially in those patients who may have multiple pain points

What are the risks/ complications?

• Short-term addiction
• Although rare, there is a possibility of a headache
• Allergic symptoms to medications, like rashes
• The injection point may get infected
• Bleeding, if a vein is accidentally harmed
• Non-permanent paralysis resulting in impairment of the bladder or bowel

Conclusion

An epidural injection is a boon to the medical industry if used wisely and with all the precautions. But it may prove to be problematic if used carelessly; even a little carelessness while using this injection may cause serious complications.

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