This is a very safe procedure with few significant risks. Few patients complain of side effects but occasionally problems are experienced. The commonest complaint is a temporary aggravation of the symptoms over one, two, or even three days. Very rarely patients get general symptoms related to absorption of the corticosteroid into the circulation. This generally only occurs either when larger doses are used or in some patients who are more sensitive to corticosteroids. In diabetics this absorption can increase the blood sugar levels –which should generally be checked several hours after the is a risk of local damage to the soft tissues at the injection site. Tissue atrophy (a thinning or weakening) of the skin or subcutaneous fat (found just beneath the skin) rarely occurs when the injected material is very close to the surface. Tissue atrophy can also involve deeper structures. It is more likely with repeated injections at the same location. Some patients find that the injection gives them pain relief for a few months, but then the pain comes back and they wonder about the safety of having another injection. Although the exact risk of multiple injections is not known, most doctors would advise against injection more than 3-4 times a year to avoid tissue atrophy. This is more important when the injection is being done in areas in which there is already significant wear or tear (torn tendons or ligaments). extremely rarely people are allergic to the injected medication (as with any drug). The exact risk of this is not known. There is a risk of infection, which is very small and probably lies between 1 in 20,000 and 1 in 75,000 injections performed. The procedure should not be performed if there is broken skin or infection overlying the bursa, or if the bursa may already be infected. Recent studies show steroid injections should probably not be given within 3 months of a planned total joint replacement as there is a slightly higher risk of postoperative infection of the prosthesis.
Epidural injections can be performed from several different approaches; these include a caudal, interlaminar, or transforaminal approach. The approach your provider chooses is based on each individual patient’s clinical presentation, the personal preference and experience of the provider performing the injection, the desired outcome, and most importantly, the risks versus benefits of performing one type of epidural over another. Clinically, the purpose of all epidural injections is to place a mixture of steroid and local anesthetic at the source of the problem to decrease inflammation causing pain, and to promote healing and clinical improvement. The epidural steroid injection involves placing steroid medication in the inflamed area and significantly reduces nerve irritation thus improving pain. This treatment option has the potential to completely resolve pain and ultimately may prevent operative treatment.