Performed by – Sri Chatakondu, Sarmad Kazzaz, Mark Thomas, Adam Way

Indication for Epidural
An epidural of steroid is given to reduce the inflammation in the lower back. It is both used to help you with your pain but also can be useful for the surgeon/pain doctor to establish the cause of back or leg symptoms. It is generally given to treat a disc prolapse, pinching of the nerves, called stenosis or disc degeneration.

Procedure
It is a day case procedure, where you will be admitted onto a ward, consented by the doctor and will discuss the procedure with the anaesthetist, who will usually give you some sedation to make it as comfortable during the epidural as possible i.e. you will be very sleepy and unaware of the epidural procedure. The needle is placed at the base of the spine, dye to used to ensure correct position and the epidural is given.You may experience some leg or groin numbness for 12-24hours after the procedure, which can be entirely normal.

Risks

• Infection – There is a very small risk of infection due to puncture of the skin
• Haematoma – A blood clot causing nerve irritation is very rare but we shall therefore advise you about certain medications (Clopidogrel, Warfarin)
• Bladder retention – Sometimes the local anaesthetic can numb the nerves to the bladder and stop usual function. This is rare but sometimes requires a catheter to be inserted
• Nerve damage – A very rare complication
• Headache – Sometimes the canal that lines the spinal cord and brain can be punctured and this can lead to a headache, which will settle after a few hours/days.

Follow-up
You shall be followed up in clinic about 4-6 weeks after the epidural to establish the benefit. It is important you keep a mental note of the benefit from the injection so this can be relayed in clinic.