Epidural steroid injections are generally very safe, but there are some rare potential complications. One of the most common risks is for the needle to go too deep and cause a hole in the dura, the tissue that surrounds the spinal cord and nerve roots. When this occurs spinal fluid can leak out through the hole and cause a headache . This headache can be treated with bedrest, or with a blood patch. A blood patch involves drawing some blood from the vein and the injecting it over the hole in the dura. The blood forms a seal over the hole and prevents any further fluid from leaking out.
The ‘Two-Pin’ technique increases sanitation for multiple dose vial users. They draw with the first pin, and then shoot/inject into the body with a new one. This procedure prevents any residual contaminants that may have remained on the drawing pin from being transferred into the body via the injection site. It also makes injection less painful since the drawing needle is necessarily dulled during passage through the rubber stopper atop the vial. A dulled needle increases injection pain because it doesn’t pierce the body as cleanly as an unused one. The protocol below is followed by AAS users who draw from multiple dose vials, but steps 4 - 8 are routinely disregarded by those users who draw from ampoules (also called ampules) and sachets.
Epidural steroid injections are most commonly used in situations of radicular pain, which is a radiating pain that is transmitted away from the spine by an irritated spinal nerve. Irritation of a spinal nerve in the low back ( lumbar radiculopathy ), such as from lumbar spinal stenosis , cervical spinal stenosis, herniated disc , and foraminal encroachment, causes back pain that goes down the leg. Epidural injection is also used as a minimally invasive procedure to treat nerve compression in the neck (cervical spine), referred to as cervical radiculopathy , which causes pain.