Epidural injections

An epidural injection delivers anti-inflammatory medication into the epidural space, which is located just outside of the sac of fluid around the spinal cord.

Interlaminar Epidural Injections

An interlaminar epidural injection targets the nerves that run from the spinal cord out to the legs and arms. This type of injection can help reduce inflammation and alleviate lower back, leg, neck, and arm pain caused by herniated discs, sciatica, misaligned vertebrae, and other back problems.

Patients may experience pain relief within 30 minutes after the injection. However, the pain may return a few hours later once the anesthetic wears off. Long term pain relief typically begins two to three days after the procedure, once the steroid has begun to take effect. Long-term pain relief may last a few months or longer.

Spinal column model with syringe used to perform epidural injection

Digital illustration of low back pain before epidural injection

Transforaminal Epidural Injections

A transforaminal injection is done to treat back or leg pain that has persisted for more than four weeks, is severe, and hasn’t improved with other treatment, such as medication and physical therapy.

Patients may benefit from a transforaminal injection if they have:

Pain in the lower back, legs, and feet
Sciatica
Herniated discs
Other back problems

Damage to the roots of nerves that run from the spinal cord to the legs can cause irritation and inflammation, leading to pain that radiates from the back to the legs and feet. The epidural is injected into the back, between the spine and spinal cord.

What to Expect During The Procedure

Upon arriving at the clinic, the patient will be instructed to change into a gown.

They will then lie face down on an X-ray table and a pillow will be placed under their stomach.

The physician will cleanse the injection site and numb the area with medication. The patient may also be given medicine to help them relax.

The doctor will proceed to insert a needle into the back, typically under X-ray guidance. A mixture of steroid and numbing medicine will then be injected into the area to decrease swelling and pressure on the larger nerves around the spine and to alleviate pain. The numbing medicine will also be used to identify the nerve causing pain.

During the injection, the patient may feel some pressure but shouldn’t experience any pain. It’s important not to move during the procedure to ensure the injection is done in precisely the right location.

The patient will be watched for 15 to 20 minutes after the injection before being allowed to go home.

Patient with low back pain needing epidural injections

Risks of Epidural Injections

The risks of this procedure are low, but rare complications may include

Bleeding or infection at the injection site
Dizziness, headache, or feeling sick to your stomach (typically mild)
Nerve root damage with increased pain down the leg
Allergic reaction to the medication
Possible rare brain and nervous system problems
Difficulty breathing if the injection was done in the neck

Temporary side effects may include numb or weak legs, dizziness, and headache. Patients should speak to their physician to find out if they are good candidates for epidural injections.