Epidural Injections Specialist

The Pain, Spine, and Sports Institute

Rehan Ali, MD

Pain Management Specialist located in Paramus, NJ

Q & A

Epidural Injections Q & A

Epidural Injection

Most of the time, your spine nerves are damaged or inflamed due to disc herniation or spinal stenosis. The inflamed spinal nerves can cause pain in your neck, arm, back, and leg.

What is an Epidural Injection?

In cases where you are experiencing pain in your neck, arms, back, or legs, your goal would be to reduce pain and get back to your day-to-day activities. While physical therapy helps reduce the pain gradually, the more effective immediate solution would be an epidural injection.

An epidural injection is an injection that goes into the space outside the membrane that protects your spinal cord. This space is called the ‘epidural space.’ The injection delivers steroids directly into your epidural space. Additional fluid is sometimes used to flush out inflammatory agents from around the area which may be the source of the pain. The procedure is usually not uncomfortable and is performed by an anesthesiologist, radiologist, neurologist, physiatrist, or a surgeon.

Who is a Candidate for an Epidural Injection?

You may be aware that an epidural injection is given to pregnant women to relieve the pain during delivery. But did you know that it can also be administered for other reasons? Patients with severe pain in the neck, lower back, arm or leg can also benefit from it. It is administered to those with the following conditions:

  • Degenerative disc
  • Herniated disc
  • Sciatica
  • Spinal stenosis
  • Spondylolisthesis

An epidural injection has proven helpful for a few patients in the treatment of inflammatory conditions. It also helps determine whether surgery is required if you have a herniated disc. Epidurals ease your pain and let you continue physical therapy when the pain interferes with your rehabilitative exercises.

What Can I Expect During the Epidural Treatment Procedure?

Dr. Ali at The Pain, Spine and Sports Institute will review your medical history before confirming whether you are the right candidate for the procedure. He will also discuss your allergies, the medications you are taking and may prescribe other medications based on your health. You will be asked to stop taking blood thinners several days before the procedure. The procedure usually takes 15 to 30 minutes.

You will be asked to lie on the X-ray table in a slightly curved position or with a pillow under the stomach. The skin on your lower back is cleaned and numbed using local anesthesia. Using live X-ray/fluoroscopy, Dr. Ali will insert a needle into the skin and direct it towards the epidural space. The fluoroscopy is vital to guide the needle to the epidural space and avoid misplacing the steroid injection. You will experience some discomfort during this step, but patients more commonly report feeling pressure than pain.

Where on My Body Can I Receive an Epidural Injection? 

The needle entry site differs depending on the condition being treated:

  • Cervical epidural: The needle entry site is from the side of the neck to reach just above the opening for the nerve root and outside the epidural space.
  • Lumbar epidural:  The needle entry site is slightly off midline of the back to reach the nerve canal.
  • Caudal epidural: The needle is placed above the tailbone to reach the lowest spinal nerves.

Once the needle is in its position, the contrast dye is injected to confirm the needle location. Adjustments if any, are made, and the epidural steroid injection is injected into the space. We will monitor you for 15 to 30 minutes after the procedure before you are discharged.

If you are suffering due to pain and are looking for relief from inflammation or discomfort in your spine, arms or legs, please reach out to us and we will be more than happy to help you find freedom from your pain.





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