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STEROID
INJECTIONS What
is this procedure? There
are several types of steroid injections performed at INDIAN RIVER RADIOLOGY.
These are normally done for pain management and are considered
a treatment procedure. The
following are the most commonly requested injection procedures; Epidural
Steroid Injection (cervical, lumbar or thoracic spine), Facet Injection
(cervical, lumbar or thoracic spine), Selective Nerve Root Block
(cervical, lumbar or thoracic spine), Costovertebral Joint Injection,
Pars Injection, Coccygeal Injection, Sacroiliac Injection, Hardware Injection
and Intradiscal Steroid Injection (cervical, lumbar or thoracic spine). How
is it done? These
procedures are performed by one of our Radiologists under fluoroscopic
guidance using a small amount of contrast material to insure proper placement
of the steroid medication. The
steroids used are not “body building” steroids, they are anti-inflammatory
medications designed to attach to the surrounding nerves and nerve root
sleeves in an attempt to reduce irritation and swelling.
Depending upon the site to be injected, the patient usually is
lying on his/her side on a special table that allows for fluoroscopic
viewing at all angles (the table remains stationary and the x-ray “C-arm”
can be rotated to achieve angled views).
A small amount of local anesthetic (similar to what a dentist would
use) is injected into the area of interest before the injection of steroid. A special needle is inserted into the site through which the
steroid medication will be infused. Steroid
injections may be performed multiple times in one body area or several
areas. However,
due to the amount of steroid being injected each time, it is recommended
to wait at least three weeks in between injections.
It may take several days for the steroid to produce pain relief.
The procedure is performed at our office on an “out patient”
basis. How
do I prepare for an ESI? If
the patient is taking an antibiotic, these procedures should not be scheduled
until the patient has completed all of the medication and there is no
indication that an infection is still present.
Occasionally, it is necessary for the patient to be cleared by
the referring physician to determine that there is no active infection
present. Patients
who are taking medications for blood pressure, diabetes, arthritis or
other health conditions most likely will be able to continue them as prescribed.
If a patient is taking an anticoagulant (blood thinner), aspirin
or Vitamin E it is required that these medications be discontinued approximately
10 days before the procedure. It
is also necessary that the patient notifies his or her personal prescribing
physician before any medications are stopped.
Serious side effects may occur if a patient discontinues medication
without first consulting the prescribing physician. Any
side effects? The
following may or may not be noticed as a side effect after a steroid injection;
irritability; fair-skinned patients may experience flushing of the skin;
increased appetite; water retention; low-grade fever; headaches; and,
diabetic patients may have their blood sugar out of range.
These side effects are not considered abnormal and usually subside
after 24 to 48 hours. Allergic
to “x-ray dye”? Patients
having a history of allergic reaction to radiographic contrast material
(“x-ray dye”) may still have these procedures, however, Indian
River Radiology should be notified at the time the patient is scheduled. Dependent upon the type of procedure requested and the type
of previous allergic reaction, the procedure may either be performed without
the use of contrast material or, in most cases, the patient can be pre-medicated
prior to the procedure in order to prevent an allergic reaction.
Pre-medication does not guarantee that a reaction will not occur,
however. After-care
at home… Following
the procedure you are advised to rest for the remainder of the day.
Avoid strenuous activity, including prolonged walking and driving.
These activities will increase soreness.
You may resume your normal diet.
If your back is sore where it was injected, apply an ice pack to
the area. Please
call our nurse, Dianne Pennella, RN, if you have any other questions about
ESI’s. (561)569-9745 |
