An epidural steroid injection (ESI) is an anti-inflammatory medicine that is delivered into the epidural space. Epidural space is an area present outside the sac of the fluid around the spinal cord. It should not be mistaken with epidural anesthesia which is given before certain types of surgeries or just before childbirth. It is also referred to as back pain injection, steroid injection-epidural, Spinal injection for back pain, Steroid injection – back.
The CPT code of Epidural Steroid Injection is 64483.
Procedure:
The procedure is performed in an outpatient clinic or hospital.
- The patient will be changed into the gown and will be made to lie on an x-ray table by inserting a pillow under the patient’s stomach. If this is painful, you have an option to either sit up or lie on your side in a curled position.
- The back area where the needle should be inserted is cleaned by the healthcare provider. Medicine is used in the same area to make it numb. The patient might be given medicine to relax.
- After this, the doctor inserts a needle on the patient’s back. He utilizes an x-ray machine to get real-time images so as to check the position of the inserted needle in the patient’s lower back.
- A mix of numbing and steroid medication is injected in the area to decrease the pressure and swelling on the larger nerves around the patient’s spine to help him soothe. The numbing medicine will also help the doctor in spotting the painful nerve.
- The patient might feel the pressure during the injection. This procedure is not painful. There should be no movement in the body during the procedure as the injection needs to be precise.
- The patient is observed for 15 to 20 minutes after giving the injection. Then the patient is discharged after observation.
Why the Procedure is Performed
The doctor may suggest ESI if there is any pain spreading from the lower spine to the hips and then to down the leg.
This pain is mainly due to the pressure on the nerve as it leaves the spine due to the bulging of a disk.
ESI is helpful when pain is not reduced with medicines, physical therapy, or other nonsurgical treatments.
Risks
ESI is a safe process generally. Rarely the complications may include:
- Mild headache, feeling sick in stomach, dizziness, etc.
- An increase in pain down the leg may lead to nerve damage
- Infection around/in the spine( referred to as abscess, meningitis)
- Allergies might show up due to the side effects of the medicine
- Bleeding around spinal column – Hematoma
- Problems with the brain and the nervous system might show up
- The patient might experience difficulty in breathing in the neck
Consult the doctor if you have any complications in the above-mentioned list.
Also, having these injections on a frequent basis can weaken nearby muscles and bones of the spine. Receiving higher doses of steroids through injections may cause issues.
Generally, most doctors suggest 2 or 3 injections per year.
Before this procedure, the doctor might ask for a ct or MRI scan in order to treat the area exactly.
Before the Procedure
Keep informed the following before going for the procedure:
- If the patient is pregnant or about to be pregnant.
- Medicines and supplements consumed by the patient.
After the Procedure
There might be slight discomfort in the injected area for a few hours due to the insertion of a needle. You can take it easy for a day. Generally, pain fluctuates for 2 to 3 days since steroids take 2 to 3 days to work.
If the doctor gives you medicines to make you sleepy then you will have to ask someone to drive home.
Outlook (Prognosis)
ESI provides pain relief for the short term to at least one-half of the people who undergo this process. Symptoms might stay for several weeks to months and in rare cases, they stay up to a year.
This procedure doesn’t cure back pain. It is necessary for patients to visit hospitals for treatment or exercise.
Epidurals are helpful to lessen inflammation in a local area, reducing pain and resetting the pain pathway in a patient’s body. They are useful to target medicine that is sent to the area of pain.
For More Visit : zeamed.com
Source:
https://medlineplus.gov/ency/article/007485.htm