Epidural Blocks

An epidural block is an injection of pain medication (it blocks pain)  into the epidural space.  You can do epidurals for the neck or the low back.  They are rarely done for the mid-back (thoracic spine).

The epidural space is the area around your spinal cord and spinal nerves.  Medications injected include local anesthetics (drugs like Novocain) and steroids (the strongest anti-inflammatory drugs).  These medicines act on the nerves to stop them from transmitting pain signals.

Epidurals for low back pain are similar to the epidurals given to pregnant women during labor.  The needle is placed in about the same location.  The medications which are injected for labor are, however, different than those used for back pain.

Epidurals are given in such a way that the medications spread out and cover all of the nerve roots in the low back or the neck.  They differ from selective blocks in that selective blocks are done for just one or two nerves.

Where will the medicine be injected?

An epidural block may be performed in any area of the spine. The medicine is injected between the vertebrae in the area where the affected nerves connect.  The skin is numbed with a small needle and then the epidural needle is inserted through the skin.

Most people describe the procedure as slightly uncomfortable. The area is numbed before the procedure to diminish the "sticking" sensation of the injection. Some pressure or cramping may be experienced, and occasionally a small "shock" sensation is felt. People who have had two or more back surgeries in the area may experience more discomfort due to the presence of scar tissue. You will be fully awake during the procedure, though some doctors may provide you sedation before the procedure.

How long will it take?

You can expect to be in the doctor's office for about one to two hours. When you arrive, we will review some information with you, place an intravenous catheter in your vein, and attach monitors to watch your heart rate, blood pressure and oxygen levels. The actual procedure takes only 10 to 15 minutes. You will then be taken to a recovery area for monitoring and discharge teaching.

You may have some extremity numbness for a short while after the procedure. You will be discharged when you are stable, usually within 30 minutes after the procedure.

Are there any restrictions afterward?

You will not be permitted to drive yourself home because the medicines used can cause drowsiness, slow response, and reduced coordination. Otherwise, you are free to eat, drink, or move normally, although we recommend you take it easy the rest of the day. You should avoid heavy lifting or excessive bending, twisting, pushing, and pulling, until all of your blocks are completed.

Go to the next page on selective nerve blocks.

Go to the next chapter on major procedures.

 

Go to the chapter on medicines and orthotics.

 






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Last modified: 07/27/08