What is an epidural injection?

An epidural injection is an injection into the epidural space, which is enclosed by layers surrounding the spinal cord and spinal nerves. The clinician will decide which technique would suit your pain:

• Lumbar Epidural - needle inserted midway of lumbar spine
• Caudal Epidural - needle inserted in tailbone
• Transforaminal Epidural - needle inserted through side opening of spine     

Why do I need to have the injection?

The injection is done to relieve pain and inflammation around the nerve or structures in the epidural space. It is used to help leg pain (sciatica) and paraesthesia (pins and needles).  Sometimes these injections improve back and referred leg pain.

Who does the procedure?

The injection is usually carried out by a Specialist Consultant in the Injection Room in the Outpatients Department. An X-ray machine may be used to guide the injection.

What is injected?

The injection consists of a steroid and sometimes may also include a local anaesthetic.

Important information

Before your injection you must inform the Outpatient department staff if you are:

• pregnant or may be pregnant,
• diabetic,
• feel unwell,
• have an infection, cold or persistent cough,
• have any allergies,
• taking any of the following medication: Antibiotics, Asprin, Warfarin or Clopidrogrel or other tablets taken to thin the blood (some of these may need to be stopped some days before).  

Failure to do so may result in your procedure being cancelled on the day.

How effective is the injection?

For many people epidurals produce noticeable improvements in symptoms. However, they do not work for everyone and their effectiveness cannot be predicted. The effects can last for weeks, months or even years and epidurals can be repeated if symptoms return.

What are the risks of this procedure?

• Infection
• Damage to small veins when the needle is inserted
• Bleeding causing local bruising or bleeding around the nerve.
• Damage to the lining around the nerve (Dural puncture) which may cause a severe headache for a few days.
• Nerve damage
• Adverse reaction to injection which may be mild or life threatening (anaphylaxis)
• Urinary complications (incontinence or    difficulty emptying your bladder)
• If you are diabetic, then the injection may raise your glucose levels. Glucose levels should be monitored for up to 1 month after your injection. If there are any changes in diabetic symptoms, then patients should consult their GP.
• Facial flushing for a few days
• Temporary discomfort for a few days after your injection.
• For females - temporary alteration of your menstrual cycle.
• Other side effects - soft tissue injury, toxicity, weak legs, weak arms, vasovagal attacks, blindness.

Please note: the risk of complications with this procedure are small. Please discuss any concerns with the clinician looking after you.

On the day of your procedure  

• Please arrive at Outpatients no more than 10 minutes before your appointment time.
• If a relative or friend brings you in, they can accompany you to the admission reception, where you will be booked in and handed in to the care of the Outpatients team.
• Relatives/friends wishing to stay on site are welcome to use the restaurant facilities in the main hospital building. Long stay parking is available at Gate A and C.
• Take any medication as normal unless advised otherwise. Bring a list of your tablets with you.
• This is a starved procedure - you must not have food 6 hours prior to admission and no water 2 hours prior to admission
• You will be admitted to Outpatients and assessed by a nurse. This is to make sure you are fit and ready for the epidural. You will have the opportunity to ask any questions at this stage.
• The Doctor carrying out your epidural will also see you before you have the procedure.
• As your epidural is being carried out as a day case you will normally be admitted for half a day. You may be asked to stay overnight but this is unusual.

What will happen after the epidural?

You will be asked to rest on a bed/trolley for about an hour after the epidural, during which time you will be monitored by the nursing staff who will check your:

• Blood pressure
• Injection site
• Once you have passed urine you will be able to make arrangements for going home.

You must not drive yourself home or use public transport. For your own wellbeing we advise that you are collected by a relative or friend. Hospital transport can only be booked if there is a medical need and you meet the set criteria.

Back at home

• It is important that you take things easy for the rest of the day.
• Do not do any excessive exercise or heavy work for the first few days.
• If a dressing is in place, remove the dressing the morning following your procedure.
• Continue to take your pain relief tablets until you notice an improvement in your symptoms.

Follow up appointment

Need for a follow up appointment or telephone appointment will be discussed before you are discharged.

Can’t make your appointment?

If for any reason you cannot make your appointment you must let the scheduled care coordinator know as soon as possible. You can contact the department on 0121 827 3835, Mon-Fri, 8.30am to 4.00pm. Your appointment will not be automatically re-booked unless you call to tell us you are not coming.

Useful contact numbers

PALS - 0121 685 4128
Scheduled Care Coordinator - 0121 827 3835      
Injection Suite - 0121 685 4000 extension 55814