This treatment is called a lumbar epidural and it is used to treat back pain, particularly where the pain is also felt in your leg or foot. Pain relief may be obtained by injecting steroid and local anaesthetic into the epidural space.

On the day of the procedure you will come to the Clinic where you will be asked if you agree to the treatment and be asked about your current medications. You will be checked by the nurse to make sure you are fit enough for the procedure.

Please arrange for someone to bring you to the Clinic and to take you home. You must not drive for the rest of the day.

The Procedure

The procedure will be done in the theatre. You will be placed on your left side with your knees brought up towards your chin. Alternatively, you may be asked to sit on the side of the couch curled over a pillow.

The doctor will clean your back with warm solution and cover your back with sterile drapes and will then inject local anaesthetic. The epidural needle is advanced slowly through the skin into your back. You may feel some pressure as the local anaesthetic and the steroid is injected.
You will return to the ward and will need to lie flat for up to 1 hour. The nurse will check your blood pressure. Your feet will get warm and tingly and may go quite numb for a short time. You may experience pain relief straight away, which will last for a few hours. It then takes the steroid up to 1 week to work. You will be allowed home when the feeling and strength return to your legs. You are advised to rest for the next 24 hours. If this treatment is successful in relieving your pain it can be repeated after 3 months, and again if needed.

Complications

Complications will be discussed with you on the day. Occasionally, your blood pressure may drop too low and you may require some intravenous fluid. Other very rare complications include a dural tap where the needle pierces the lining of the spine, which would cause a bad headache for a few days.

You will be able to discuss any concerns on the day with your nurse or medical practitioner.


It is important that when your pain improves that you increase your level of activity such as walking or swimming. The staff will be happy to advise you.

Websites for Information

If you have any questions please ask a member of the nursing staff who will be happy to help you. You may find other useful information at:
www.backcare.org.uk or www.britishpainsociety.org

Frequently Asked Questions

WHAT IS CORTISONE?

Cortisone is a powerful anti-inflammatory medicine which reduces inflammation around the nerve tissue and can break into the cycle of entrapment and swelling. This reduces pain, numbness, weakness.

IS THERE A LIMIT TO THE NUMBER OF INJECTIONS YOU CAN HAVE?

In any particular place in the body there is a natural limit of three injections in a 6 week period. Further injections are allowed in other places and at other times especially if they are effective. Your specialist will guide you.

WHAT COMPLICATIONS MAY OCCUR?

Hot flushes for 2 days. (Quite rare)

Allergic reaction to any injection may occur in 1 in 7000 cases. This may just be a rash or a life threatening reaction. These will usually occur immediately and will be treated immediately. Most reactions are treated and cause no permanent harm.

Bleeding - Epidural Haematoma and resulting nerve damage is a very rare (1 in 7000) complication after a bleed around the nerves. This usually requires surgery to remedy.

Infection – Very rarely (1 in 7000). An epidural abscess or infection in other tissues can occur rarely. You should watch for signs of fever, redness, swelling and increasing pain. This can be treated with antibiotics or even surgery.

Spinal Fluid Leak – This causes a very bad headache, nausea/vomiting which goes away on lying down. This rarely lasts