Epidural Steroid Injection Patient Information

Pre-Procedure Instructions:

1. Antibiotics and Infections: If you are currently taking antibiotics or being treated for an infection, please contact our office before your injection appointment.
2. Procedure Overview: You have been scheduled for an epidural steroid injection to treat pain and determine if your pain originates from the spinal nerves. The injection will include local anesthetic, corticosteroids, and a small amount of contrast dye. Inform us if you have had any adverse reactions to these medications in the past.
3. Driving and Transportation: The local anesthetic effect can last several hours, potentially causing temporary numbness or weakness. For your safety, do not drive on the day of the procedure. Please arrange for a driver to accompany you or arrange transportation after the appointment.
4. Fasting: Refrain from eating or drinking for four to six hours before your appointment time. You can eat and drink immediately following the injection.
5. Routine Medications: You may take your routine medications as scheduled on the day of the injection with a small sip of water.
6. Anxiety and Sedatives: If you experience anxiety about the procedure and would prefer a light sedative, please notify our office at least 24 hours in advance. 
7. Blood-Thinning Medications: If you are taking any blood thinning medications (Plavix®, Coumadin®, Aggrenox®, Lovenox®, Xarelto®, aspirin), inform our office for specific instructions on discontinuing them. The following general guidelines apply:
   • Plavix®: Stop for 7 days prior to the appointment (cardiologist clearance needed if you have cardiac stents).
   • Coumadin®: Stop 5 days prior to the appointment with an INR drawn the day before.
   • Aggrenox®: Stop 7 days prior to the appointment.
   • Lovenox®: Stop 24 hours prior to the appointment.
   • Xarelto®: Stop 3 days prior to the appointment.
   • Aspirin: Stop for cervical injections 7 days prior; no need to stop for lumbar procedures.
   • Anti-inflammatory medications (Motrin®, ibuprofen, Advil®, Aleve®, etc.): Stop for cervical injections 5 days prior; stop for lumbar procedures 3 days prior.

Post-Procedure Instructions:

1. Driving Restriction: Do not drive for 12 hours after the injection.
2. Soreness and Ice Therapy: Mild soreness at the injection site(s) for 24-48 hours is common. Apply ice for 20 minutes at a time several times a day as needed.
3. Heat Avoidance: Avoid heat to the injection area for 72 hours. Refrain from using hot packs, saunas, or steam rooms during this time. Regular showers are permitted.
4. Medication Resumption: You can immediately resume your regular medication regimen, including pain medications, anti-inflammatory drugs, and blood thinners.
5. Dressing Removal: Remove the sterile dressing/band-aid the night of the injection or the following morning. Do not leave it on after showering or getting it wet.
6. Corticosteroid Side Effects: Corticosteroid side effects may occur but usually resolve within several days. These side effects can include flushing, hot flashes, mild palpitations, insomnia, water retention, restlessness/anxiety, or headaches.
7. Infection Signs: While rare, if you notice signs of infection after the procedure (fevers/chills, severe increased pain, redness at the injection site, or any drainage), contact our office at 424.254.3592.