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Epidural Steriod and Selective Nerve Blocks

What is the purpose of an epidural or nerve block?

These injections are given for relief of low back or leg pain. The injections will help determine where your pain is originating from.

What is an epidural or nerve block injection?

An epidural injection widely distributes medication to multiple nerves in the lower spine. It is generally done when more than one nerve is affected. A selective nerve block delivers medication to only one nerve. This will help identify which nerve is specifically responsible for your sypmptoms.

Epidural and Nerve Block Procedure

These procedures take approximately 30 minutes. While lying on your stomach, the area around the lower back or tail bone will be cleansed with an antiseptic solution and a local anesthetic administered. For an epidural injection the radiologist, using fluoroscopy, will direct small needle into the epidural space (the space between the sac which contains the spinal cord and spinal fluid, and the vertebrae). A small amount of x-ray contrast will be injected to ensure proper placement of the needle. A steroid medication and a local anesthetic will then be injected.

A nerve block is very similar to an epidural injection but instead of the needle entering the epidural space it is placed next to a single nerve where it exits from the spinal canal. The remainder of the procedure is the same.

Does Health Care or Insurance cover this procedure?

Alberta Health Care will cover the cost involved with this procedure. The Workers Compensation Board will also cover this procedure if you have a claim number.

Pre-Injection instructions

  • There is no restriction to your diet.
  • You will need someone to drive you home.
  • Please reduce any pain medication (Advil, Tylenol, etc.) the day of your appointment, so that you have enough discomfort (but not extreme) to determine if your procedure has been effective in relieving your symptoms. If you are in pain despite your medications, you do not need to decrease them. Please do not stop any pain medication that has been prescribed by your doctor without consulting him or her first.
  • You must have your doctor’s approval before you discontinue taking anticoagulants. Inform your doctor and the radiologist if you are allergic to iodine, contrast material or dye, are diabetic or taking anti-coagulants. If you are taking anti-coagulants, you must discontinue use of them 4-5 days prior to your appointment. You will also be required to have "STAT" INR blood test done the day prior to your procedure.
  • Please note that the procedure cannot be performed if you have an active infection or are on antibiotics. The medication used will reduce the effectiveness of the antibiotics. Your appointment will need to be rescheduled.

Post-Injection instructions

  • After your procedure you will be required to remain in the radiology department for approximately 30 minutes to "rate your pain" post injection.
  • You will be given a pain diary to take home to document your pain level associated specifically with the treated area.
  • You may resume normal activities as tolerated after the procedure. Unless there are complications, you should be able to return to work the same day.
  • It is recommended that you follow up with your referring physician or physiotherapist.

Are there risks?

Generally this procedure is safe; however with any procedure there are risks, side effects and the possibility of complications. You may feel some pressure or other mild discomfort during the injection. Occasionally you may experience local bruising. Rarely, the local anesthetic may spread to nearby nerves and cause temporary weakness and numbness. On rare occasions, a patient will have an adverse reaction to contrast material used.

If you feel you may be a candidate for this procedure, speak with your family physician about a referral or arrange for a consultation with an Evidence Sport and Spine physiotherapist at the Advanced Spinal Care Centre for an evaluation.

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