Next Thursday at 9 am and, Yes, I Am Scared

The covering over the nerve roots in the spine is called the dura. The sleeve-like space surrounding the dura is called the epidural space. Nerves travel through the epidural space before they travel into your arms, chest or legs. The nerves leave the spine from small nerve holes. These nerves may become inflamed due to irritation from a damaged disc or from contact with a bone spur ... Inflammation of these nerves in the thoracic spine may cause pain in your mid-back, along your ribs, to your chest wall or abdomen...

An epidural injection places anti-inflammatory medicine (cortisone) into the epidural space to reduce nerve inflammation, and hopefully reduce your symptoms. By stopping or limiting nerve inflammation we may promote healing, and speed up “mother nature”, thereby reducing your pain. Although not always helpful, epidural injections reduce pain and improve symptoms in most people within 3-7 days. They may provide permanent relief or provide a period of pain relief that will allow other treatments like physical therapy to be more effective ...

First, an IV is started so that you may be given medicine for relaxation if you so desire. (DARN RIGHT I DESIRE SEDATION) Next, while lying face down on a x-ray table your skin will be well cleansed with an antiseptic. The physician will numb a small area of skin over your spine where the epidural needle will be inserted. Next, the physician will use x-ray guidance to direct a small needle into the epidural space. There will be pressure felt with this part of the procedure. He will then inject contrast dye to confirm that the medicine spreads to the affected nerve(s) in the epidural space. After this, the physician will inject a combination of numbing medicine (anesthetic) and time released anti-inflammatory (cortisone).

You may have some partial numbness in your arms or legs from the anesthetic after the injection. This may last several hours but you will be able to function safely as long as you take precautions. You will report your remaining pain (if any) and also record the relief you experience over the next week in a “pain diary” which we will provide ...

You may notice an increase in your pain lasting for several days. This occurs after the numbing medicine wears off but before the cortisone has a chance to work. Ice will typically be more helpful than heat during this time. You may begin to notice an improvement in your pain 3-5 days after the injection. Improvements will generally occur within 10 days after the injection.

*all material (except for my editorial DARN RIGHT I DESIRE SEDATION) from the physician who will be performing the epidural injection.