medilaw.tv - malpractice multimedia. This movie illustrates the pain management technique for performing a cervical interlaminar epidural injection in the sitting position. This movie shows patient positioning, skin preparation, local anesthetic injection, needle introduction into the epidural space, contrast injection to check needle tip position in the epidural space, steroid / anesthetic injection, and finally wound dressing. malpractice multimedia.
An epidural injection is used to inject medication into the epidural space around irritated spinal nerves. Spinal nerves can be irritated by herniated or degenerative discs, facet joint osteophytes, enlarged ligaments or traumatic or infectious inflammation. The injected medication can include local anesthetic, slow-release anti-inflammatory steroid and opioid pain-relieving medication. Epidural injections can be diagnostic or therapeutic. The amount of immediate pain relief from the local anesthetic is diagnostic of the degree to which the nerves are a source of your pain. This information will assist with the selection of further treatment options. Once the source of the pain is known, therapeutic injections can be given to provide pain relief. Steroids act as an anti-inflammatory to decrease pain and swelling. Opioids increase the pain relief. In addition, the injection fluid also helps to flush out inflammatory pain-causing proteins. The injection can provide ongoing pain relief so that a rehabilitation program can be undertaken.
INDICATIONS
The indications for an epidural injection are
- to assist in the identification of the cause of neck or arm pain
- to provide relief of pain caused by disease of the intervertebral disc, spinal nerve root, or adjacent structures.
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ALTERNATIVES
The non-surgical alternatives to epidural injection may be
- activity modification
- weight loss
- aerobic exercise, such as walking, cycling, and swimming
- strength and flexibility exercises
- physical therapy
- hydrotherapy
- heat and cold pads
- acupuncture
- oral pain-relieving medications such as acetaminophen or paracetamol, non-steroidal anti-inflammatory drugs, glucosamine, chondroitin
The surgical alternatives to epidural injection may be
- pain management injections or ablations
- surgical decompression or possibly fusion
- disc replacement surgery
- oral steroid medication (may not be as effective).
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GOALS
The goals of an epidural injection are to either assist in identifying the structure causing your pain, or to decrease the pain caused by that structure.
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TECHNIQUE
Your neck will be cleaned. A local anesthetic injection will numb the skin. This may sting for a couple of seconds. A needle will enter the epidural space. Fluoroscopy, an X-ray TV, is often used to help guide the needle to the correct location. Some contrast dye may be injected to check the exact position of the needle tip. Then the medication will be injected, the needle removed and a small bandage placed on the skin.

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