Epidural and Facet Injections
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If your doctor has asked the radiologist to do a special spinal procedure – either an epidural injection or a facet injection - this document describes how to prepare for, what to expect from, and care instructions for after either of these injections.
This spinal procedure may be done for:
- Back pain
- Sciatica (pain going down the back of the leg)
- Diagnostic reasons, to identify symptoms and plan for your care
- Therapeutic reasons.
Before an Epidural or Facet Injection Procedure
- Do not eat or drink anything two hours before your procedure is scheduled.
- It is OK to take your normal medications with a small sip of water.
- If you take blood-thinning medication such as coumadin (Warfarin), Plavix, or Lovenox, consult with your primary care provider about stopping it prior to this procedure and restarting it after the procedure is done.
- If you are diabetic and take insulin, check with your doctor about adjusting your dose during the time you are not allowed to eat. If you are taking pills for diabetes, let the radiologist know on the day of your procedure.
- If you are allergic to contrast “radiology dye,” please tell your referring doctor. He or she may want to prescribe medications that you will need to take before the procedure is done.
- Arrange to have someone drive you home. For your safety, do not drive until the day after your procedure.
Your Epidural Injection Procedure
An epidural is an injection that delivers medication directly into the epidural space in your spine. The epidural space surrounds the spinal cord and spinal nerves.
- The radiologist will clean your lower back with an antiseptic solution and numb the area where the needle will be inserted.
- After the area is anesthetized, the radiologist will insert a different needle into the epidural space using the X-ray machine for guidance, and will inject contrast to check the position.
- A steroid (a medication to reduce inflammation) mixed with a local anesthetic is injected through the needle into the epidural space. The needle is removed after this is done. You may feel some pressure while the steroid is being injected.
- You will be observed for 30 minutes before going home.
Your Facet Joint Injection Procedure
The facet joint is the space between two vertebrae (bony) parts of the spine that are separated by a thin layer of cartilage. An abnormality or inflammation of these joints may cause low back pain.
- The radiologist will clean your skin and inject it with licocaine to make it numb.
- After the area is anesthetized, the radiologist will insert a different needle into the area between the two vertebrae (the facet space) using the X-ray machine for guidance.
- A combination of contrast, a numbing medication, and a steroid is injected. You may experience some pressure during the injection. The needle is then removed.
- You will be observed for 30 minutes before going home.
What to expect from your procedure
With either of the two procedures, you may have complete relief of
your pain. This may be due at first to the direct effects of the
numbing medication used in the procedure. Your pain may return as the
numbing medication starts to wear off, but improve in several days to
weeks if the steroid is successful in relieving your symptoms. If the
procedure works, relief can last weeks or months.
You may have
no relief from your symptoms after the procedure. Your doctor might
then order another procedure. If several injections are done over a
period of weeks, more injections are unlikely to provide relief.