An epidural injection is similar to a nerve block or nerve root injection, except that in this case, the injection is administered into the epidural space inside the spine.
Most commonly, this is carried out in the lower parts of the spine, ‘Lumbar or Caudal’ epidurals, but they can also be carried out in the Cervical (neck) or Thoracic spinal regions.
Epidural injections target nerves and discs inside the spine, for example when pain is due to a cracked or bulging intervertebral disc, when there may be back pain and sciatica, or neck and arm pain.
The injections contain depot cortico-steroid (a type of steroid that reduces inflammation) and sometimes also local anaesthetic. The procedure is slightly different from a regular injection as it involves a thin needle being inserted into the spine, just into the epidural space. This will be done under the guidance of X-ray in an operating theatre, with local anaesthetic, so the consultant can see precisely where the needle is going, and you may be sedated first to ensure you’re as relaxed as possible. Once the needle is in place, a dye is administered to check that the medication is reaching the targeted area, followed by the steroid and any further local anaesthetic needed.
Afterwards, you may be groggy, and will be monitored briefly before you go home. You won’t be able to drive for at least 24 hours, until the sedative has completely worn off, so will need somebody to accompany you home. There may be some bruising and soreness at the site of the injection, but this should settle within a few days. In more rare cases, there may be some temporary weakness or floppiness in the limbs linked with the nerves being treated. Your consultant will be able to discuss side-effects with you and how to manage these. You should be able to resume regular daily activities the next day but may be advised to avoid strenuous exercise for a while.
Epidural injections are not 100% effective and the results aren’t always immediate. However, many people experience very significant improvements sometimes very quickly after the injections have been administered, that can last anything from a number of days to many months, and the condition can settle or heal during this time, perhaps helped by physiotherapy.