Epidural injections are injections into the spinal area. They can deliver painkillers, steroids, or other anti-inflammatories and are sometimes used in diagnosis of disease. Both the neck and back parts of the spine can be injected. Epidurals carry certain risks including paralysis.
The spine is made of vertebrae that are stacked on top of each other in a column, and the column is surrounded by a fluid-filled sac covered by a membrane. Epidural injections target the area outside the membrane known as the epidural space. The medication can reach nerves inside the spinal cord in this manner.
A doctor can use an interlaminar approach, which simply means placing the needle into the epidural space for the medication to cover a wide area. He or she could opt to place the needle into the bottom of the spine by using a particular bone called the sacral hiatus as a guide. Alternatively, the doctor can inject medication as close to the affected nerve as possibly by placing the needle into the sleeve surrounding the nerve itself.
People who need localized painkilling medication may receive the drug through epidural injections. Situations that are suitable for epidural painkillers include pain after major surgeries and during caesarean sections. Women experiencing severe pain during labor may also opt for epidurals. The injection reduces the sensation of pain in the bottom half of the body and allows the mother to stay alert during the birth. Epidural injections usually prevent a mother from moving around, but an option is a combined epidural and spinal injection called a "walking epidural," where the mother retains enough strength in her legs to be able to walk.
Certain conditions are caused by inflammation of nerves in the back, and these can result in pains in the legs or arms. These issues can also be treated with epidural injections. Steroids injected into the area help reduce the swelling and inflammation that cause the pain.
The injections allow doctors to get the medication close to the affected area, and this feature of epidurals can be used to help find the source of a disease. A doctor may inject a patient in a certain location with a painkiller or a steroid and see if the affected nerve is in that location by judging the relief the patient gets from the medicine. Possible risks from epidural injections include nerve damage, an allergic reaction, or accidental damage to arteries or veins by the needle.