Steriod 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 office if you have any questions (772) 569-9745.