Treating Herniated disk in the lower back (slipped, ruptured or bulging disc)

25 Apr, 2022

Spinal injections

Epidural injections help treat lower back pain in conditions related to spinal canal narrowing, nerve pressure from disc hernia, or degenerative disease. Using X-ray, anesthetic and steroids can be injected around the nerves into the spinal canal (interlaminar) to help alleviate symptoms.

Pain relief can occur within two weeks and last from three to six months, if not more. MRI is often required for this treatment to confirm diagnosis by selecting the specific region of the spine's epidural space and avoid complications.

How do I prepare for my procedure?

  • Wear comfortable clothes
  • Have a driver pick you up
  • Recent MRI or CT results within the last 24 months or less are required
  • If you have undergone surgery recently, but haven't taken new X-ray images, please inform the pre-injection booking coordinator
  • If you are taking anticoagulant medications such as Plavix, Clopidogrel, Coumadin or Warfarin, you may need to take an International Normalized Ratio Test (INR) and temporarily stop the medication before the procedure. Please inform our booking coordinators to discuss this in more detail with you
  • If you have diabetes, please have something to eat an hour before your appointment
  • Please arrive 15 minutes prior to your scheduled appointment

What happens during the procedure?

  • A team member will explain the approval form, details of the procedure and answer all your questions.
  • We will then escort you to our treatment ward where you will meet with a radiologist who will clean the skin and inject a topical anesthetic, similar to the anesthesia you may receive at a dentist.
  • Under X-ray guidance, the needle is placed accurately on your spinal canal. To double check the accuracy of the injection spot, a short-acting drug is injected, as well as a nervous system test. Once the injection position is confirmed, the drugs are injected.
  • You might feel pain or pressure similar to your normal back pain when injecting medication. That's a good sign and means the medicine is going to the right place. The pain usually dissipates quickly.
  • A bandage will be placed at the injection spot and you will then be transferred in a wheelchair to another room.
  • In 15 minutes, you will be examined for the expected injection response. If you can stand and walk safely, you will be free to leave with your driver.
Post-procedural instructions

First 24 hours after the procedure:

  • Keep the area where injected clean. Do not rip off the bandage or take a shower
  • Avoid driving.
  • If possible, avoid anti-inflammatory medications such as ibuprofen for 24 hours
  • You might feel fatigue, formication or tingling in one or both legs. This is normal and might last for four to six hours.

First 48 hours after procedure:

  • Avoid bathtubs, hot tubs and swimming pools
  • Avoid engaging in strenuous activities and lifting weights for three to five day.

Within a week:

You can resume your regular activities, lift objects and undertake physiotherapy. Pay attention to your pain and stop all activities if you feel pain. Inform your physiotherapist that you've received this treatment so they can adjust your exercises if necessary.

  • Watch out for infection: if you have symptoms such as increasing pain, redness of the skin around the injection spot, or body temperate above 38.5°C, proceed to the urgent care center or Emergency Room.
  • Monitor bleeding down the spine: If you suffer from severe bursts of pain in your lower back or the pain has moved down one or both legs, please call 911 or proceed immediately to the Emergency Room.
  • If you have a headache that gets better when you lie down but gets worse when you sit down, drink caffeine such as coffee or tea, take Tylenol (Paracetamol), and rest. If the headache continues the next day, consult your family doctor and seek medical care.
  • If you feel any pain or showed other symptoms within 48 hours of the procedure, please contact the Emergency Room.