Epidural Steroid Injection

What is epidural steroid injection?

Epidural steroid injection is a medical procedure that involves the administration of a dose of pain-killing medication into a small space in your back or neck. Epidural steroid treatment usually involves a series of up to three injections, repeated at regular (weekly) intervals. This treatment has brought relief to many patients who suffer from pain caused by local inflammation, such as bulging discs, arthritis or ligament strain.

How quickly can I expect pain relief?

Relief is not instantaneous, but most patients report that initial benefit is felt 2 to 5 days after the first injection and maximum relief is reached 1 or 2 weeks after the last injection.

How should I prepare for the procedure?

The epidural steroid injection is a safe medical procedure but, as with any procedure, it has risks as well as benefits. To minimize the chance of complications, we ask that you follow a few simple guidelines:

Do not eat or drink anything 6 hours prior to the procedure. An exception is always made for routine scheduled medication, which you can take with a sip of water.

We require that a responsible adult driver accompany you to and from the Advanced Pain Institute. Physicians at the Advanced Pain Institute may offer a small dose of relaxing medication prior to the injection, which could impair your driving ability.
Plan on spending about 90 minutes at the Advanced Pain Institute. This includes time for patient registration, preparation, performance of the procedure and observation.

What happens during the procedure?

First, an intravenous line will be placed, generally in your hand or arm. We will initiate continuous monitoring of your heart, breathing and blood pressure. You will then be asked to either sit or lie on your side on the treatment bed. Sometimes, X-ray guidance aids in appropriate placement of the medication. Once the equipment has been positioned, you may be offered a sedative medication to help you relax.
After cleaning a small patch of your skin, a local anesthetic is injected into the skin to decrease any pain associated with the procedure. The steroid medication is then administered through a small needle. The procedure itself is very brief, usually less than five minutes.
Occasionally, patients describe a recurrence of their normal back pain during administration of the medication. This is viewed as a reassuring sign that the medication is going to the right place, and the sensation usually disappears quickly.

What happens after the procedure?

After the epidural steroid medication has been injected, we will continue to monitor you for about 20 minutes. If there are no signs of problems, you will be ready to leave. You may go to the reception area and schedule your follow-up injections. We will provide your physician with a written record of the procedure and will keep him/her informed of your progress during the entire course of treatment. If you have any questions after your procedure, the medical staff of the Advanced Pain Institute is on call 24 hours a day, seven days a week. During normal business hours and after hours (doctor will be paged), you can reach either the nurse or physician by calling (626) 445-2371.

Will my insurance cover the procedure?

The epidural steroid injection is a well-established medical procedure and is reimbursed by most insurance companies. Any need for preauthorization of services or copayments depends on your insurance carrier. Our office staff will assist you in obtaining preauthorization whenever possible. The same copayments you make at your family physician’s office will often apply at the Pain Management Center.