Injected cortisone is synthetically produced and has many different trade names (Celestone, Kenalog, etc.), but is a close derivative of your body's own product. The most significant differences are that synthetic cortisone is not injected into the blood stream, but into a particular area of inflammation. Also, the synthetic cortisone is designed to act more potently and for a longer period of time (days instead of minutes).
Epidural Injections
An epidural steroid injection places this powerful anti-inflammatory medication directly around the spinal nerves. An epidural injections can be administered with or without the aid of imaging to allow your physician to see the needle going to the proper spot. The procedure can be performed in a sitting position, or lying down. Some patients are more comfortable when given a light sedation to keep them calm.Epidural steroid injections may be given by many types of physicians, including anesthesiologists, orthopedic surgeons, neurologists, interventional radiologists, pain management specialists, and others trained in this technique. Often a series of injections, up to three, each spaced a week apart, are given. With this schedule, many patients find relief of symptoms within a few weeks. Often this helps control the inflammatory process and may provide long-lasting relief.
Side-effects from epidural steroid injections are rare, but should be discussed. These include:
- Infection: Very unusual (less that 0.5%), and usually avoided by using a sterile technique.
- Bleeding: Also unusual, and avoided by not performing this procedure on patients with bleeding disorders or those on blood thinning medication.
- Dural Tears: Caused by piercing the sac around the spinal nerves with the needle. This usually results in a headache.
- Increased Blood Sugar: Diabetics must carefully monitor their blood sugar after this or any other steroid injection.
Other side-effects are possible, and should be discussed prior to injection with the doctor performing this procedure.
