What is an epidural injection?
“Epidural” refers to the space surrounding the outer protective covering of the spinal cord.
For some people, an injection into the epidural space can help to relieve back pain or sciatica (shooting pain from the back down one or both legs) at least in the short term. This period of pain relief may allow them to become more active. Keeping active is crucial to recovery from chronic back pain.
The epidural injection for chronic back pain consists of a steroid, a local anaesthetic or a combination of the two. These drugs are put into the epidural space using a special needle. The position of the injection depends on which spinal nerves are responsible for the pain. This is usually in the lumbar region of the back (below the level of your lowest rib).
The procedure is routinely carried out as a day-case, with no overnight stay. The injection is usually given under a local anaesthetic. This means you will stay awake during the procedure, but you may be offered a sedative to help you relax.
The treatment is usually given in an operating theatre or in the X–ray department. During the procedure, your doctor will take X-ray pictures to ensure the needle is correctly placed in the epidural space. The procedure can be uncomfortable because it is being given in an area that is already painful.
The treatment usually takes 10 to 20 minutes to complete. Afterwards, the needle is removed and the site is covered with plasters or a dressing. Before you go home, you will need to rest on your bed within the daycare ward or your room in the hospital.
You may feel sore at the site of the injection for the first 24 hours or so and your symptoms of back pain may actually get temporarily worse, before they begin to get better. You may have a headache for a day or two.
It can take up to a week for the full benefits of an epidural injection to be felt. The effects of a successful injection can last anything from a few weeks to several months. Repeat injections (usually up to a maximum of three) to the same area of the back may be given over a six-month period.
About facet joint injections
The facet joints link together the bones in your back. They help to stabilise the spine and control the degree of movement. With age, they are prone to injury and deterioration and are a common cause of lower back pain, especially the type that is worse while sitting and improved by walking.
An injection into a facet joint is given to treat the pain, inflammation and any restriction of movement caused by the deterioration. A steroid medicine (which reduces inflammation) or a combination of a steroid and a local anaesthetic is injected into the joint.
Facet joint injections are usually performed as an out-patient or day-case procedure with sedation. Some people have the injections done under general anaesthesia, which means that they are asleep during the procedure.
Facet joint injections are usually done with you lying on your tummy. A thin needle is passed through the skin on your back into the facet joint. The steroid and anaesthetic mixture is injected into the joint. The treatment usually only takes a few minutes and more than one joint can be injected during the same session. As with epidural injections, your consultant will take X-ray pictures to ensure the needle is correctly placed in the facet joint.
Facet joint injections can be uncomfortable because they are given in an area that may already be painful. You will need to rest on a bed for about two hours before you go home.
After a facet joint injection you may feel more pain and tenderness in the area during the first 24 hours as the anaesthesia wears off. Sometimes this lasts for a few days. You will be given painkillers to help with this.
It can take up to a week for the full benefits of the injection to be felt. The effects of a successful injection can last anything from a few weeks to several months. The benefits last longer than six months only in a minority of people. Repeat injections (usually up to a maximum of three) are possible.
Epidural injections and facet joint injections are generally safe. For most people, the benefits in terms of pain relief are greater than any disadvantages. However, all medical procedures carry an element of risk.
It’s important to realise that injections do not work for every patient and some people find their back pain reoccurs or their pain and mobility does not improve.
A possible complication of any injection into the spine is that the treatment reaches unintended parts of the spinal cord. This can cause a drop in your blood pressure or widespread numbness. Your doctor monitors you constantly and will be able to notice this quickly, and provide appropriate care.
Your doctor will explain the benefits and associated risks with having an epidural or facet joint injection and also discuss any alternatives to the procedure. The chance of complications depends on the exact type of procedure you are having and other factors such as your general health. Ask your doctor to explain how any risks apply to you.
To make an appointment or to get a guide price, please call our enquiry team on 0800 434 6600.
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