Epidural Pain Blocks

This is a procedure done under x-ray guidance where steroid is injected into the epidural space. This procedure can be done in the neck (or cervical), mid-back (or thoracic), and low back (or lumbar). These procedures are often used to treat pain that arises from a pinched nerve, degenerative disc disease, a herniated disc, or spinal stenosis. The steroid in injected directly at the level of the spine where the problem is coming from, and it helps to relief pain by reducing inflammation and pressure in that part of the spine.

Nerve blocks can be used to manage chronic (or long-term) pain, pain after surgery, severe acute (or short-term) pain. They ease pain by offering immediate relief. They can also offer longer-term relief because some injections reduce irritation to the nerves and let them heal.

For people who have chronic pain, nerve blocks can help them function better in their daily lives, allowing them to go to work, exercise, and do daily tasks.

Temporary nerve blocks are often a short-term fix. The pain may return within as little as a few hours after the drugs wear off. Some people may need to be repeated or even long-term nerve block treatments to manage inflammation and pain.

Nerve blocks are often used during surgeries to ease pain and can also help relieve cancer-related pain as well as migraines and occipital neuralgia.

Done by a trained, qualified professional, nerve blocks are considered safe. However, like all procedures, nerve blocks do have some risks.

A nerve block can lead to bleeding and infection where the shot was given, the medicine may spill into other areas unexpectedly, and healthcare providers may hit the wrong nerve during surgery. However, compared with many procedures, nerve blocks appear to be quite safe. 

Before the day of your procedure, a nurse will call to confirm the time you should arrive at the surgery center. This may vary slightly from the time you were originally given as other procedures scheduled before or after yours may have canceled or changed.

The nurse will review the medications you take and any medical conditions you might have. You probably have answered these questions before, but it is important that this information is checked and rechecked to be certain no errors are made.

Please follow your specific instructions, but there are some general preparations:

• You should not eat or drink for six hours before the procedure.
• Your nurse or doctor will inform you which of your regular medications to take or avoid the day of your procedure.
• You must arrange to have someone remain at the Surgery Center until you are discharged and to drive you home afterward. (Usually, you will be at the Surgery Center for two to three hours or less.)

When you arrive at the Semmes Murphey Clinic Surgery Center, check-in on the second floor with the receptionist to receive your armband and beeper. The beeper will indicate when it’s time to be taken to the pre-procedure area.

After check-in, you will change into a hospital gown. Another nurse will review the questions you were asked the day before. If an IV is required for your procedure, it will be started in your hand or forearm.

The doctor performing the procedure will come talk to you and answer any questions you have.

The procedure itself is performed in an X-ray room. After being positioned on the table the nurse will administer some sedation through your IV. The sedation will leave you feeling drowsy and relaxed, but you will not be “put to sleep” for these minor procedures. It’s not uncommon, though, for patients to not remember the procedure afterward. Most interventional pain procedures take less than 20 minutes to perform.

After the pain block is complete, you will be sent to the recovery area for monitoring for 30 minutes or so to allow the effects of the sedation to wear off and to be certain you have no adverse effects from the procedure. Some patients will feel some numbness or weakness in their legs for 45 minutes or so after the procedure, but this is temporary.

Your driver may come join you in the recovery area. The nurse will go over discharge instructions and medications list with you and your driver. If you do not feel nauseated, the IV will be discontinued and you will be assisted to stand and take a few steps.

After your successful recovery, a nurse will give you discharge instructions and you will go home.

You will be here approximately two to three hours (or less) from the time you check-in until you are discharged.

When you arrive at your home, you don’t have to stay in bed, but you should limit yourself to quiet “around the house” activities for the rest of the day. You should not drive for at least six hours after the procedure since the effects of the sedative may slow your reaction times. Most patients resume normal activities and return to work the day after their procedure.