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Pain Management Procedures - Epidural Steroid Treatment and Side Effects

Updated on May 3, 2011

Pain Management Procedure - Caudal Epidural Steroid Injection

This pain management procedure is used to relieve the lower back and radiating leg pain. Steroids may reduce swelling and inflammation caused by stenosis, radiculopathy, sciatica, and herniated discs.

Before performing caudal steroid injection, the pain management physician places a pillow underneath the stomach and back arch for comfort. The doctor uses a fluoroscope to find the small opening at the base of the sacrum.

How a caudal epidural spinal injection is performed?

Local anesthetic is used to numb the skin and tissue to the surface of the sacral hiatus. After the needle is carefully placed in the area, a contrast solution is used to help doctors to see the painful areas using the fluoroscope. Then, a mixture of anesthetic and antiinflammatory drugs is injected into the epidural space, infiltrating the painful area with medication. The needle is removed and a small bandage is used to cover the small area of the wound.

Most patients have relief after one or two caudal epidural steroid injections, but it may be necessary to repeat the procedure several times to get the maximum benefit from medication.

Common side effects may include allergic reaction, bacterial infection, bleeding in rare cases sometimes. Side effects of steroids are face, eyes, arms, and leg swelling, increase of sugar level in diabetic patients.

The patient should tell their doctors about pregnancy or if he/she takes blood-thinning medications.

Celiac Plexus Block

This pain management procedure is used to diagnose and relieve abdominal pain caused by cancer or pancreatitis. The injection blocks the nerves serving the abdomen. The intravenous anesthetic can be used to relax the patient.

How a celiac plexus block is performed?

Local anesthetic is used to numb the skin and tissues to the celiac plexus. A doctor uses a fluoroscope and contrast dye to confirm correct placement of the needle tip. Numbing medicine is injected around the nerves to block pain signals from reaching the brain.

The first shot could be a test. If pain relief occurs, permanent block could be used. Most patients have immediate pain relief after the injection.

Common side effects are bacterial infection, allergic reaction, bleeding in seldom cases. Steroids side effects are the face, arms, eyes, and leg swelling. Some diabetic patients experience increase in their sugar level.

Sacroiliac joint
Sacroiliac joint

Steroid injection into the Sacroiliac Joint

This procedure is done to eliminate pain caused by sacroiliac joint arthritis. Sacroiliac joint is a joint that connects the spine and pelvic bone. Steroid medication can reduce swelling and inflammation. During this procedure, the patient lies face down with a soft pillow under the stomach for better comfort and to help relax the spine.

How a sacroiliac joint injection is performed?

A local anesthetic is administered at the site of injection, which numbs all tissues to the sacroiliac joint. Then, a steroid-anesthetic mixture is injected into the painful area.

Possible side effects are comparable to the effects of a single injection: Patients may have allergic reactions, bacterial infection or bleeding that rarely happens.

How a facet joint injection is performed?

This injection is given to treat the facet joints, which cause back pain, neck pain, and inflammation. Each vertebra in the spine is connected with two facet joints. A local anesthetic numbs the skin and facet joint tissue.

Pain management physicians use fluoroscopy with contrast and resolution to confirm the correct placement of the needle tip and apply their knowledge of bony landmarks. A mixture of anesthetic and anti-inflammatory steroid medication is injected into the joint. Sometimes two or more injections may be needed. If the patient feels pain relief after the injection, this confirms that the facet joint is the source of the pain.

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