What is a Thoracic Epidural Steroid Injection?
A thoracic epidural steroid injection is a minimally invasive procedure used to treat upper back pain and related symptoms. The injection delivers a mixture of corticosteroid medication and local anesthetic into the epidural space surrounding the spinal cord in the thoracic region. This can help reduce inflammation and alleviate pain caused by conditions such as herniated discs, spinal stenosis, or other sources of thoracic radiculopathy.
How is a Thoracic Epidural Steroid Injection Performed?
To perform a thoracic epidural steroid injection:
- 1. The patient is positioned sitting or lying down to expose the targeted area of the upper back.
- 2. The skin and underlying tissues are thoroughly cleaned and numbed with a local anesthetic.
- 3. Using fluoroscopic (X-ray) guidance, the physician carefully inserts a small needle into the epidural space surrounding the thoracic spinal cord.
- 4. A contrast solution may be injected to confirm the correct placement of the needle.
- 5. The physician then injects a mixture of corticosteroid medication and local anesthetic into the epidural space.
- 6. This medication bathes the surrounding nerves, helping to reduce inflammation and pain.
- 7. After the injection is complete, the needle is removed, and the injection site may be covered with a small bandage.
What Supplies and Medications are Used for a Thoracic Epidural Steroid Injection?
The key components for this procedure include:
- Local anesthetic (e.g. lidocaine or bupivacaine) to numb the injection site
- Corticosteroid medication (e.g. triamcinolone, methylprednisolone) to reduce inflammation
- Fluoroscopic imaging equipment to precisely guide needle placement
- Contrast solution (optional) to confirm proper needle positioning
The physician selects the appropriate medications and techniques based on the patient’s individual condition and needs.
What to Expect After a Thoracic Epidural Steroid Injection?
After the procedure, patients may experience some soreness or discomfort at the injection site, which can typically be managed with over-the-counter pain medication.
The full pain-relieving effects of the steroid medication may take 3-5 days to be realized. In some cases, repeat injections may be necessary to achieve the desired therapeutic benefit, but many patients experience significant relief from just one or two injections.
Patients should follow any activity restrictions and instructions provided by their healthcare team. They should promptly report any concerning symptoms, such as increased pain, numbness, or signs of infection, to their physician.