Epidural Steroid Injection

This information will help you prepare for your epidural steroid injection at Memorial Sloan Kettering (MSK).

About Epidural Steroid Injections

Epidural space

Your vertebrae (the individual bones in your back) are separated by rubbery cushions called discs. If a disc bulges (moves out of place), it can irritate and inflame your spinal nerves. This causes back and nerve pain. A steroid injection can help to decrease nerve inflammation, which may help to reduce your pain.

Your epidural space goes from the base of your head to the part of your spine that’s below your hips (see Figure 1). A steroid may be injected into any area of your epidural space. Your pain doctor will decide the best location for your injection based on where your pain is.

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1 Week Before Your Procedure

Ask about your medications

You may need to stop taking some medications before your procedure. We have included some common examples below.

  • If you take medication to thin your blood, ask the doctor who prescribes it for you when to stop taking it. Some examples are warfarin (Coumadin®), dalteparin (Fragmin®), heparin, tinzaparin (Innohep®), enoxaparin (Lovenox®), clopidogrel (Plavix®), and cilostazol (Pletal®).
  • If you take insulin or other medications for diabetes, you may need to change the dose. Ask the doctor who prescribes your diabetes medications what you should do the morning of your procedure.

Arrange for someone to take you home

You must have someone 18 years or older take you home after your procedure. If you don’t have someone to do this, call one of the agencies below. They will send someone to go home with you. There’s usually a charge for this service, and you will need to provide transportation.

Agencies in New York                                         Agencies in New Jersey
Partners in Care: 888-735-8913                                         Caring People: 877-227-4649
Caring People: 877-227-4649                                          

 

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The Day of Your Procedure

‌ ​​Starting 4 hours before your procedure, do not eat or drink anything. This includes water, gum, and hard candy.
 
 
 

What to bring with you

  • A list of the medications you take at home
  • Medications for pain

Where to park

MSK’s parking garage is located on East 66th Street between York and First Avenues. If you have questions about prices, call 212-639-2338.

To reach the garage, turn onto East 66th Street from York Avenue. The garage is located about a quarter of a block in from York Avenue, on the right-hand (north) side of the street. There is a pedestrian tunnel that you can walk through that connects the garage to the hospital.

There are also garages located on East 69th Street between First and Second Avenues, East 67th Street between York and First Avenues, and East 65th Street between First and Second Avenues.

Where to go

Your procedure will take place at MSK’s main building. The best entrance to use is the entrance located at 425 East 67th Street, between York and First avenues.

At the hospital, take the A elevator to the 3rd floor. Your procedure will take place in room A341.

What to expect

Once you arrive at the hospital, you will be asked to state and spell your name and date of birth many times. This is for your safety. People with the same or similar names may be having procedures on the same day.

You may be asked to change into a hospital gown and remove any necklaces, chains, and earrings you’re wearing.

A pain doctor will review the procedure with you and answer your questions.

When it’s time for your procedure, you will be helped onto the x-ray table and helped to lie on your stomach with a pillow under your belly. Using fluoroscopy (a type of x-ray), your doctor will locate the best spot in your back to place the epidural and inject the steroid.

When the correct location is found, you will get an injection of local anesthetic (medication to make an area of your body numb). You may feel a small pinprick followed by a burning sensation. Your doctor will then insert the epidural in the area where the local anesthetic was injected. Once your doctor is sure that the needle is correctly placed, they will inject the steroid. The needle will be removed and a bandage will be placed over the injection site.

This procedure takes 45 to 60 minutes to complete.

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After Your Procedure

At home

For the first 24 hours after your procedure:

  • Don’t shower
  • Don’t drink alcoholic beverages
  • Don’t drive or do any other task where you need to be alert
  • Don’t remove the bandage from your injection site. You can remove it 24 hours after your procedure.
  • Take your pain medication as prescribed.

Your pain may increase for up to 24 hours after your injection. This is normal. You may take an extra dose of your pain medication to help relieve your pain. If this pain continues longer than 48 hours, call your doctor.

It may take 3 days or more before you feel the full benefit of the steroid injection.

Side effects

Some patients develop side effects after getting an epidural steroid injection. The most common side effects are:

  • Headaches
  • Temporary weakness, numbness, or tingling in your arms and legs
  • Some soreness at your injection site
  • A feeling of fullness in your back
  • Sleeplessness
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