WHAT SHOULD I DO AFTER THE PROCEDURE?

You should have a ride home. We advise the patient to take it easy for a day or so after the procedure. Perform the activities as tolerated by you.

CAN I GO TO WORK THE NEXT DAY?

Unless there are complications you should be able to return to work the next day. The most common thing you may feel is a sore back.

HOW LONG WILL THE EFFECTS OF THE MEDICATION LAST?

If the doctor used local anesthetic you may notice an immediate effect. This wears off in a few
hours. The cortisone starts working in about two to three days and its pain relieving effects can last for several days, many months, or indefinitely.

HOW MANY INJECTIONS DO I NEED TO HAVE?

There are three possible responses to your first injection; complete relief, partial relief, or no pain relief. If the first injection does not relieve your symptoms in about a week or two weeks, you will not have the same injection repeated. If you get partial relief we usually recommend you have a second one and possibly even a third injection within 4-8 weeks of the first injection. If you get complete relief we want you to call in, if the relief wears off, we would offer you a repeat injection
at that point. In the first six months we generally do not perform more than three injections. This is because the medication injected lasts for about six months. If three injections have not helped you much, it is very unlikely that you will get any further benefit from more injections. Also, giving more injections will increase the likelihood of side effects from the cortisone.

WILL THE EPIDURAL STEROID INJECTION HELP ME?

It is impossible to predict if the injection will indeed help you or not. Generally speaking, the
patients who have "radicular symptoms" or "sciatica" (buttocks and leg pain, numbness, tingling) respond better to the injections than the patients who have only back pain. Similarly, the patients who have not had pain for very long may respond much better than the ones with pain for more than six months.

WHAT ARE THE RISKS AND SIDE EFFECTS?

Generally speaking, this procedure is safe. However, with any procedure there are risks, side
effects and the possibility of complications. The most common side effect is pain at the injection
site and lower back, which is temporary. The other risks are very rare and include spinal puncture with headaches, infection, bleeding inside the epidural space with nerve damage, worsening symptoms etc. The other risks are related to the side effects of cortisone. These include temporary
weight gain, temporary increase in blood sugar (mainly in diabetics) and water retention.

WHO SHOULD NOT HAVE THIS INJECTION?

If you are allergic to any of the medications to be injected, if you are on a blood thinning medica-
tion (e.g. Coumadin, Heparin, Plavix ), if you are or could be pregnant, or if you have an active infection going on, you should not have the injection.

WHAT SHOULD I DO WITH THE PAIN LOG I AM GIVEN?

If you are given a Pain Log and record, then you will be asked to rate your pain 3-4 days
following the injection. Rate only your typical pain, do not include soreness from the injection!