Microsoft word - cervicalepidural.doc
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CERVICAL EPIDURAL INJECTION INFORMATION
What is the epidural space?
The covering over the nerve roots in the spine is cal ed the dura. The space surrounding this
dura is the epidural space. Nerves travel through the epidural space before they travel down into
your arms. The nerves leave the spine from smal nerve holes. Inflammation of these nerve roots
may cause pain in your neck, shouder or arms. These nerve roots may become inflamed due to
irritation from a damaged disc or from contact with bone spurs.
What is an epidural injection and why is it helpful?
An epidural injection places anti-inflammatory medicine into the epidural space to stop
inflammation of the nerve roots, therefore hopeful y reducing the pain in the neck, shoulders, and
By stopping or limiting nerve root inflammation we may be able to reduce your pain. The
epidural injection may assist the injury to heal by reducing inflammation. Although not always
helpful it usual y reduces pain and improves function in the majority within 3-7 days. It may provide
permanent relief or provide a period of pain relief that wil al ow other treatments like physical
therapy to be more effective. We hope it wil reduce your pain during the next several months while
the injury/cause of your pain is healing.
What will happen to me during the procedure?
First an IV is started so that you may be given medicine for relaxation if you so desire. Next,
while lying face down on a x-ray table your skin wil be wel cleaned. The physician wil numb a
smal area of skin in the back of your neck which may sting for a few seconds. Next, the physician
wil use x-ray guidance to direct a smal needle into the epidural space. There wil be pressure felt
with this part of the procedure. He wil then inject contrast dye to confirm that the medicine spreads
to the affected nerve root(s) in the epidural space. After this, the physician wil inject a combination
of numbing medicine and time release anti-inflammatory cortisone.
What should I do after the procedure?
You wil wait 30-60 minutes in recovery before going home. No driving for eight hours. Please
record your pain relief during the next week on a “pain diary” we wil provide to you. Mail the
completed pain diary back Spine Specialists. If you experience complete relief or more than 90%
relief of your pain we wil not repeat the procedure. If you experience partial relief it may be
beneficial to repeat the procedure in about two weeks. If you experience no relief, notify the office
and the procedure wil probably not be repeated. We perform a maximum of three epidurals each 2
General Pre/Post Instructions
You should eat a light, but not a ful meal at least 2 hours before the procedure. If you are an
insulin dependent diabetic do not alter your normal food intake. Take your routine medications
before the procedure
(such as high blood pressure and diabetes medications) except stop aspirin
7 days before the procedure and al anti-inflammatory medications (e.g. Motrin/Ibuprofen, Aleve) 3
days before the procedure. These medicines may be re-started the day after the procedure. You
can continue to use Celebrex before the procedure. You may take your regular pain
medicine as needed before/after the procedure. If you are on blood thiners (e.g. coumadin,
lovenex, plavix or ticlid you must notify my office so that the timing of stopping these medications
can be explained. If you are on antibiotics please notify our office, we may wait to do the procedure.
If you have an active infection or fever we will not do the procedure.
You wil be in the hospital
as an out-patient for 2-3 hours even though you see the physician for 20 minutes. You will need to
bring a driver who must stay with you
. You may return to your current level of activities the next
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