An epidural steroid injection places this powerful anti-inflammatory medication directly around the spinal nerves. Traditionally epidural injections were administered without any special equipment, by inserting the needle by feel in the area around the spinal nerves. More recently epidural injections have been administered with the aid of imaging tools to allow your physician to see the needle going to the proper location. Either real-time x-ray called fluoroscopy, or CT scan can be used to 'watch' the needle deliver the medication to the proper location.
Corticosteroids are used to control inflammation in arthritis and other inflammatory conditions. Corticosteroids can be injected directly into inflamed tissues, or they can be delivered to the whole body via oral preparations, intravenous injections, or intramuscular injections. Steroid injections may provide significant relief to patients with arthritis or musculoskeletal conditions. For patients with rheumatoid arthritis , the injections are typically offered when only one or two joints display active synovitis . The goal of treatment is to quell symptoms of a flare or to enable slower-acting drugs, such as methotrexate or Plaquenil , time to work. For example, in early rheumatoid arthritis, study results revealed that a combination of DMARDs and intra-articular steroids is significantly better than DMARDs alone.
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.