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Osteopaths do not carry out epidural injections, but patients sometimes ask what they are and how and if they work. Epidural injections can help provide short-term pain relief for people with sciatica.. The injection is given by an anaesthetist. It involves injecting local anaesthetic and steroids into the epidural space that surrounds the spinal cord. Local anaesthetic drugs numb the spinal cord nerves instantly and the steroid helps by reducing swelling (inflammation).It can take up to a week for the full benefits of an epidural injection to be felt.
The effects of a successful injection only last from a few weeks to several months. If the injection helps reduce pain, it can be repeated every two months.
The Medicines and Healthcare products Regulatory Agency (MHRA) has not formally licensed the use of steroids for chronic back pain and sciatica. Doctors commonly prescribe medicines in this off-label way in both NHS and private hospitals, but you should be aware that this is the case before the medicine is given.
Epidural injections are used to provide anaesthesia for surgery, and/or control pain after surgery. They are also used for pain relief during childbirth. This type of epidural is not discussed here.
The procedure is routinely done as an out-patient or day case. You will stay awake during the procedure, but you may be offered a sedative to help you relax. Typically, you must not eat or drink for six hours before sedation. However, you may be allowed occasional sips of water until two hours beforehand.An epidural is generally a safe procedure. However, in order to make an informed decision and give your consent you need to be aware of the possible side-effects and the risk of complications.
Side-effects are the unwanted but mostly temporary effects of a successful procedure. These can include the following.a drop in blood pressure - after the epidural drug is given, you will have your blood pressure monitored for about 20 minutes; drop in blood sugar levels - if you have diabetes, your doctor will check your sugar levels after the epidural, but you must also keep a close check on sugar levels when you go home.; loss of leg strength or control of the leg muscles - this wears off with the anaesthetic. ; he injection area may feel sore. ;back or leg pain may actually get worse, before it begins to get better.
Complications are when problems occur during or after the procedure. Most people are not affected. The main complications specific to epidural injections are : headache - if the epidural needle nicks the covering of the spinal cord, there may be a small leak of fluid from around the cord, which can cause a severe headache lasting for up to a week.; bleeding - there are many blood vessels around the spinal cord and occasionally one will be pricked as the epidural needle goes in.; infection - this is uncommon because the skin is cleaned before the (sterile) needle is inserted. .; long-term numbness - some people have patches of numbness lasting up to three months. ;permanent damage, such as paralysis (complete loss of sensation and movement) is very rare. ; allergic reaction - it's possible to have an allergic reaction to the drugs or the contrast dye. If you feel itchy or have difficulty in breathing tell your doctor immediately. Medicines are available to treat any allergic reaction. ; no effect - it's important to realise that epidural injections do not work for every person and some people may find their pain does not improve. You should ask your doctor to explain how these risks apply to you. The exact risks will differ for every person.
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