An IV is started and sedation is given. You will not be under general anesthesia. Pathology in the spine can cause distortions that push the nerve into areas that it normally does not reside. As we approach the foramen, we will cautiously advance the needle and ask for any signs of bumping the nerve. You may feel a mild parasthesia into your leg, which will allow us to adjust the needle accordingly. Practitioners putting patients under general anesthesia place you at risk of injecting into the nerve, which could have long lasting consequences. Once the area is localized, dye is injected under live X ray to confirm proper needle placement. Anti-inflammatory steroid is then injected and the procedure is complete.
An epidural steroid injection places this powerful anti-inflammatory medication directly around the spinal nerves. Traditionally epidural injections were administered without any special equipment, by inserting the needle by feel in the area around the spinal nerves. More recently epidural injections have been administered with the aid of imaging tools to allow your physician to see the needle going to the proper location. Either real-time x-ray, called fluoroscopy, or CT scan can be used to 'watch' the needle deliver the medication to the proper location.