Diagnostic and Therapeutic Selective (Transforaminal) Epidural Spinal Injection
What will happen to me during the procedure?
First, an IV is started so that you may receive medicine for relaxation if needed. Next, while lying on an x-ray table your skin will be cleansed with an antiseptic. The physician will numb a small area of skin where the epidural needle will be inserted.
Next, the physician will use x-ray guidance to direct a small needle next to the spinal nerve as it leaves the spine. He will then inject contrast dye to confirm that the medicine spreads to the affected nerve(s) and into the epidural space where the inflammation resides. 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 arm, chest or leg 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 may or may not obtain improvement in the first few hours after the injection, depending upon if the nerve that was injected was your main pain source.
You will report your remaining pain (if any) and also record the relief you experience over the two weeks on a “pain diary” we will provide. Fax, email or mail the completed pain diary in the envelope provided so that your treating physician can be informed of your results and plan future tests and/or treatment if needed.
You may take your regular medicines after the procedure, but try to limit your pain medicines the first 4-6 hours after the procedure so that the diagnostic information obtained from the procedure is accurate.
On occasion 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 7-10 days after the injection.
On the day of the injection you should not drive and avoid any strenuous activities.
On the day after the procedure you may return to your regular activities. You can start your regular exercise program in moderation 3-5 days after the injection. Even if you are significantly improved, gradually increase your activities over 2-3 weeks to avoid recurrence of your pain.