Diagnostic epidurography is intended to help ensure that an epidural will be effective for you. The procedure is done to assesses the structure of the epidural space in your spine before epidural steroids are administered to ensure accurate delivery of this therapeutic material to the source of your pain.
These examinations are performed to pinpoint the cause of your pain and reduce symptoms; and the epidural steroids are intended to decrease inflammation and swelling that may be present. Pain relief will vary for each patient.
What to Expect
- We’ll contact you prior to your appointment to review current medications, your medical history, and potential risks. We’ll also answer any questions you have about the procedure.
- Be sure to tell us if you are pregnant, nursing, or if there is a chance you may be pregnant.
- Please arrange to have someone drive you home after the procedure.
- On the day of your exam, please arrive 15 minutes early to check in.
- Although complications are rare, we will review possible side effects and risks with you prior to your exam so you can ask questions and decide if this exam is right for you.
- When you arrive, you will be led to a changing room and given a pair of scrubs to wear for your exam. You will be given a locker to store your clothes, and anything else you may have with you during your exam.
- You will lie on an X-ray table and the skin in the targeted area will be cleaned and then numbed with a local anesthetic.
- Using a form of real-time X-ray called fluoroscopy for guidance, a radiologist will insert a thin needle into the skin and direct it toward the epidural space using imaging to confirm the location.
- Once a needle has been carefully inserted into a central location in the spine, contrast dye will be injected. The X-ray allows your radiologist to document how the contrast dye disperses to help diagnose the source of your pain.
- Most epidurographies are followed by an epidural steroid injection into the source of your pain. For this, a combination of an anti-inflammatory (steroid) medication and anesthetic (numbing) will then be injected for pain relief.
- You will remain awake during the 10-20 minute procedure. You may experience some slight pressure or discomfort during the injection. Inform the radiologist if any pain differs from your usual symptoms.
- You will be asked to wait 30-40 minutes after your procedure before leaving.
- When your procedure is complete, you’ll be escorted back to the changing room so you can change out of the scrubs and back into your clothing.
- You may experience numbness and/or relief from your symptoms after the injection.
- The beneficial effects of the steroids usually require two to three days to take hold, but may take as long as five to seven days. In the first few days, it is not uncommon for your usual symptoms to return and possibly be stronger. Every patient is different and results may vary.
- If there is no change in your symptoms after a week, your doctor may want to investigate other possible sources for your pain.
- You may be asked to keep track of how long relief lasts and report it to your physician; this information is useful when considering next steps.
- If the injection blocked your pain effectively, but only for a short time, your physician may request additional injections or consider a procedure that offers more permanent relief.