Pre-Operative Instructions: Epidural Steroid Injection (2024)

Please pay close attention to the following information/instructions:

If you are currently on antibiotics or being treated for an infection, please call the office prior to your injection appointment.

1. You have been scheduled for an epidural steroid injection which is useful to treat pain and determine if your pain is coming from the spinal nerves.
2. You will be receiving an injection of local anesthetic, corticosteroids, and a small amount of contrast dye. Please inform us if you have had any previous adverse reactions to the above-listed medications.
3. The local anesthetic effect can last for several hours after your injection, and you may experience temporary numbness or weakness. We advise that you refrain from driving the day of your procedure. Please bring a driver to your appointment or arrange for someone to pick you up from your appointment.
4. On the day of your appointment, please refrain from eating or drinking 4 hours prior to your appointment time. You may eat and drink immediately following your injection.
5. If you take routine medications, you may take these on the day of your injection as scheduled with a small sip of water.
6. If you have anxiety about your scheduled office procedure and prefer to have a light sedative prescribed to take before your appointment, please notify our office at least 24 hours in advance. IV sedatives are available if your procedure is scheduled at North Bay Regional Surgery Center or Novato Community Hospital. No advanced notice is required.
7. If you are on any blood thinning medications (Plavix^®, Coumadin^®, Aggrenox^®, Lovenox^®, Xarelto^®, aspirin), please notify our office so that we may give you specific instructions about the length of time you need to discontinue these medications. In general, we follow the guidelines below:
   • Plavix^® – Stop for 7 days prior to appointment (you will need clearance from your cardiologist if you have cardiac stents in place).
   • Coumadin^® – Stop 5 days prior to appointment with an INR drawn the day before your appointment.
   • Aggrenox^® – Stop 7 days prior to appointment.
   • Lovenox^® – Stop 24 hours prior to appointment.
   • Xarelto^® – Stop 3 days prior to appointment.
   • Aspirin – For cervical injections, stop 7 days prior. No need to stop before lumbar procedures.
   • Anti-inflammatory (Motrin^®, ibuprofen, Advil^®, Aleve^®, etc.) – For cervical injections, stop 5 days prior. No need to stop for lumbar procedures.