When the thoracic spinal nerves become irritated and inflamed from a damaged disc or contact with a bone spur pain can occur in the upper back, ribs, or rarely the abdomen. In these cases, a thoracic epidural steroid injection can provide relief from pain in 50% of patients. These injections are not intended to be a cure in and of themselves, but instead, are used to provide relief from pain by Dr. Yevgeniy Khavkin while they continue their patient’s rehabilitation program proceeds.
The Anatomy Of The Spinal Nerves
Surrounding the nerve roots in the spine is a membrane known as the dura, which in turn is surrounded by the epidural space. Nerves transit through the epidural space into the arms, legs, and chest, and then pass through smaller holes for the nerves. This epidural space is where the steroid injections are made to aid in relieving pain in these areas.
How Is The Thoracic Epidural Steroid Injection Performed?
The procedure typically takes about an hour and a half, with the injection itself taking approximately 30 minutes, followed by 45 minutes spent in recovery. The following steps occur during the procedure:
- An IV is set up to provide relaxation medication if the patient and practitioner desire.
- The patient is placed on an x-ray table face down, and the injection site cleansed with an antiseptic.
- A local anesthetic is administered to the injection site.
- Using fluoroscopy a small needle will be guided into the epidural space, during which the patient may experience some pressure. The fluoroscopy is important for ensuring the needle is properly placed.
- Following the insertion of the needle, a contrast dye is injected to confirm proper placement.
- A time-release steroid and anesthetic are injected into the epidural space to treat pain.
The patient will need someone to drive them home from the appointment, and rest and relaxation will be necessary for the rest of the day following the procedure.
What Happens After The Epidural Steroid Injection?
In some cases, patients will experience partial numbness in the affected area that typically will subside within a few hours. If there is remaining pain the physician will need to be informed, and a pain diary should be kept to track relief over the week following. This should then be returned to the physician, and the physician continuing to be updated with the results afterward.
In some cases, additional pain may be experienced for several days following the procedure as the numbing medication subsides and the steroid is given time to work. Application of ice may aid in reducing the inflammation and is typically more effective than heat. In most cases, pain relief will improve after 10 days, though results may be noticed within 5.
Continued use of regular medications can continue following the epidural steroid injection, and the day after the procedure will see the patient able to return to their regular daily activities. However, exercise should be avoided until the pain subsides.
If you have any further questions about this procedure and whether or not it could be appropriate for your condition, contact your pain management doctor in Las Vegas, NV.