This information will help you prepare for your spinal injection.
 
If you have irritation and inflammation of the spine, you may be experiencing:
 
  • Neck, back, or leg pain
  • Tingling
  • Numbness or weakness that starts in the lower back and travels through the buttocks and down the large nerve in the back of the leg
There are a number of conditions that can cause irritation and inflammation of the spine, including: 
 
  • A herniated disc, or a problem with one of the rubbery cushions (disks) between the individual bones (vertebrae) that stack up to make your spine
  • Arthritis, or inflammation of the joints
  • Spinal stenosis, or a narrowing of one or more areas in your spine
  • Injury to the spine
A spinal injection using steroids, numbing medications, or both can decrease pain. Steroids help to decrease nerve inflammation and discomfort. Numbing medication (lidocaine) can be used to block the feeling of pain for a short period of time. 
 
The injections may be done at different areas of your spine (see Figure). Your doctor will decide which type of injection will be best to help with your discomfort. Types of spinal injections include:
 
  • Epidural injection, in your epidural space. The epidural space goes from the base of your head to part of the spine that is below your hips. The nerves in your back are located in this space. A steroid and numbing medication can be injected into any part of the epidural space. 
  • Facet injection, into your facet joint. The facet joint is where each vertebra connects to the next. Sometimes, arthritis can develop in the facet joints and cause pain. An anti-inflammatory steroid and numbing medication can be injected directly into the facet joints to decrease pain. 
  • Medial branch block, around your medial branch nerves. Medial branch nerves are very small nerves that control feeling in your facet joints. These nerves send pain signals from the facet joints to your brain. Numbing medication can be injected around the nerve(s) to decrease the pain.

Before Your Injection 

  • Tell your doctor:
    • About any medical conditions you have
    • If you currently have or have recently had an infection
    • If you are currently receiving chemotherapy or radiation therapy
    • If you think that you may be pregnant
    • If you are allergic to any medications, especially to iodine, contrast, lidocaine, or any antibiotics
    • If you are allergic to latex
    • If you have any implants in your body (e.g., pacemakers, Mediport, joint replacement, stents, shunts, breast implants, orthopedic hardware, etc.) 
    • If you have ever been instructed to take antibiotics before a dental procedure or surgery
    • If you are experiencing chest pain or trouble breathing
    • All the medications you are taking, including over-the-counter medications, vitamins, and herbs
    • If you are taking any blood thinners, such as aspirin, warfarin (Coumadin®), enoxaparin (Lovenox®), dalteparin sodium (Fragmin®), clopidogrel (Plavix®), or rivaroxaban (Xarelto®). We will need to speak with the doctor who prescribed it for you. We must know if it will be safe for you to stop taking the blood thinner for your injection
    • If you are taking any nonsteroidal anti-inflammatory drugs (NSAIDs), such as ibuprofen (Advil®, Motrin®), naproxen (Aleve®), or meloxicam (Mobic®)

Arrange for someone to take you home

You must have a responsible adult bring you home after your injection. If you do not have someone who can do this, please call one of the agencies below. They will help find someone to take you home.
 
  • Partners in Care: (888) 735-8913
  • Caring People: (877) 227-4649
  • Prime Care: (212) 944-0244

The Day of Your Injection 

  • You can have a light breakfast on the morning of your injection. 
  • If you take daily medication, we will tell you which ones to take on the morning of your injection. 
  • If you have been taking blood thinners, have had chemotherapy within the last month, or think that you may be pregnant, you may need to have blood tests before your injection. 
  • Before the injection, you will:
    • Sign a consent form
    • Change into a hospital gown
    • Have your blood pressure, heart rate, breathing rate, and temperature checked

The injection 

Depending on the injection site, you will lay on your abdomen (belly) or side. Using a special x-ray machine, your doctor will find the location for the injection. You will be given medication to numb your skin. Your doctor will then insert a thin needle into the injection site. Before injecting the medication, a dye will be injected to check the position of the needle. Once your doctor is sure that the needle is in the correct place, the steroid, numbing medication (lidocaine), or both will be injected. The needle will be removed and a bandage will be placed over the injection site. 
 
After the injection, your doctor will examine you and your blood pressure, heart rate, breathing rate, and temperature will be checked. 
 
This whole process usually takes about 45 minutes.
 

After Your Injection

Caring for yourself at home 

  • Keep the bandage on your injection site until the morning after the injection. You can then remove it and take a shower. Do not take a tub bath, soak in water, or swim for 24 hours after the injection. 
  • If your injection site is sore, you can apply a cold pack to the area. Apply it 15 minutes on and 15 minutes off for 24 hours. Do not put heat on or near the injection site for 24 hours. 
  • Avoid strenuous physical activity and exercise (lifting weights, running, etc.) for 1 week after the injection. 
  • If you stopped taking any medication before the injection, ask your doctor when you can start taking it again. 
  • It may take up to 1 week before you feel the full benefit of the medication. In the meantime, you can take ________________ if you have any discomfort in your spine. 
  • If you have diabetes, you will need to monitor your blood sugar after the injection. Steroids can temporarily cause blood sugar to rise. 

Call Your Doctor if You Have: 

  • Changes in your vision
  • Dizziness
  • Bowel or bladder problems
  • Increased drowsiness
  • A severe or persistent headache
  • A temperature of 100.4° F (38.0° C) or higher
  • Any new or increasing pain, numbness, tingling, or limb weakness
  • Any redness, swelling, drainage, or bleeding at the injection site
  • Any questions or concerns