Epidural Injections for Pain Relief: How They Work and What to Expect

A common technique for reducing pain during labor and surgery is an epidural injection. They deliver medication directly to the epidural space, a region surrounding the spinal cord, to numb the lower half of the body. So, let’s understand epidural injections, explaining their mechanism of action, the procedure itself, and what to expect before, during, and after the process.

Understanding the Epidural Space

A network of nerves called the spinal cord runs through the human spine and transmits information from the brain to the body’s other organs. The fatty epidural space, which contains blood vessels and cerebrospinal fluid, envelops the spinal cord. Epidural injections target this space to deliver medication directly to the nerves.

How Epidural Injections Work

Epidural injections work by interrupting pain signals sent from the nerves to the brain. Here’s a breakdown of the process:

Medication Delivery: An epidural injection involves inserting a thin needle into the lower back and into the epidural space.

Pain Relief Medication: It is a local anesthetic medication that sees usage in conjuction with a steroid or narcotic. The local anesthetic numbs the nerves, preventing them from transmitting pain signals. Steroids help reduce inflammation around the nerves, providing longer-lasting pain relief. Narcotics offer additional pain control but can cause drowsiness.

Pain Signal Blockade: The medicine bathes the nerves, interfering with the passage of pain signals from the nerves’ target location to the brain. This causes loss of feeling and pain alleviation in the lower body.

Types of Epidural Injections

There are two main types of epidural injections. Both of these serve different purposes:

Epidural Anesthesia: This type uses a higher concentration of local anesthetic medication to achieve complete pain relief. It’s quite common during childbirth and major abdominal surgeries.

Epidural Steroid Injections: These injections combine a local anesthetic with a corticosteroid medication. While the steroid lessens inflammation surrounding the nerves to give longer-lasting pain control, the local anesthetic only relieves pain momentarily. Chronic pain disorders affecting the legs and lower back are frequently addressed with this kind of treatment.

When are Epidural Injections Used?

Epidural injections have various applications, including:

Pain Management During Labor: Epidural anesthesia is a popular option for pain relief during childbirth. It allows mothers to remain awake and alert during delivery while significantly reducing pain.

Pain Management During Surgery: Epidural anesthesia is typically part of surgeries below the waist, such as cesarean sections, hip replacements, and urologic procedures.

Chronic Pain Management: Epidural steroid injections can provide relief for chronic pain conditions like sciatica, herniated discs, and spinal stenosis.

What to Expect Before an Epidural Injection

Your doctor will talk to you about your allergies, current medicines, and medical history before administering an epidural injection. Along with the surgery, possible hazards and alternate pain management alternatives will also be discussed. Depending on why the injection is being given, you might have to:

• Fast for a certain period before the procedure.
• Stop taking certain medications that can interfere with blood clotting.
• Arrange for someone to drive you home after the procedure.

The Epidural Injection Procedure

The epidural injection procedure typically follows these steps:

Preparation: You will likely lie on your side or sit hunched forward. The staff will clean and sterilize the area on your lower back.

Numbing the Area: The use of a local anesthetic will numb the skin before needle insertion.

Needle Insertion: A thin needle is carefully guided using fluoroscopy (real-time X-ray imaging) to ensure accurate placement in the epidural space.

Catheter Placement (Optional): For continuous pain relief, a thin plastic tube (catheter) may be threaded through the needle and left in place. Medication can then continuously go to the patient through the catheter.

Medication Administration: The medication is given through a needle or catheter.

The process usually takes 15 to 30 minutes to complete. Throughout the needle insertion procedure, you may experience some pressure or pain.

What to Expect After an Epidural Injection

The effects of an epidural injection will vary depending on the type of medication used:

Epidural Anesthesia: Numbness and pain relief typically begin within 10-20 minutes and can last for several hours, depending on the medication dosage.

Epidural Steroid Injections: Pain relief may not be immediate but can develop over a few days and can last for weeks or even months.

Potential Side Effects

Epidural injections are generally safe, but some potential side effects can occur. These include:

Low blood pressure: This is a common side effect, especially with large volumes of medication. You may feel lightheaded or dizzy.

Backache: Temporary backache or discomfort at the injection site is common.

Leg weakness: Temporary weakness or numbness in one or both legs can occur.

Headache: If the dura mater, the outermost layer covering the spinal cord, is pierced during the injection, a spinal headache may result. This usually resolves within a few days with fluids and pain medication.

Infection: Although rare, infection at the injection site is a possibility.

Urinary retention: The medication can temporarily affect your ability to urinate.

Recovery

Following an epidural injection, the staff will monitor you briefly to ensure your blood pressure and other vital signs are stable.

Epidural Anesthesia: Prior to transferring to a normal room, you will need to go to a recovery room if you underwent surgery under an epidural anesthetic.

Epidural Steroid Injections: For steroid injections, you can usually recover at home after the procedure.

Important Considerations

Loss of sensation: Be aware that you may lose some feeling or sensation in your lower body after an epidural injection. This can increase the risk of falls or injury. It’s crucial to avoid activities that require good balance or coordination until the feeling returns completely.

Communication: Inform your doctor or nurse immediately if you experience any concerning side effects after the injection, such as severe headache, fever, or weakness.

End Word

In essence, epidural injections are a valuable tool for pain management during childbirth, surgery, and chronic pain conditions. Understanding how they work and what to expect before, during, and after the procedure can help you make informed decisions about your pain management options. However, if you are suffering from any pain or have questions about epidural injections, it’s best to visit pain management specialists in New Jersey.