Can You Get an Epidural after a Discectomy?

A discectomy is a surgical procedure used to remove all or part of a herniated disc that is pressing on nerve roots or the spinal cord. This operation is typically performed to alleviate pain, numbness, or weakness caused by the herniated disc. The procedure can be done through traditional open surgery or using minimally invasive techniques.

Undergoing a discectomy can be a significant step toward alleviating chronic back pain caused by herniated discs. However, for some patients, pain management remains a concern even after the procedure. One question that often arises is whether it is possible or advisable to receive an epidural injection following a discectomy. In this comprehensive guide, you will learn about the relationship between discectomies and epidurals, including the potential benefits, risks, and considerations for patients contemplating this pain management option.

The Role of Epidurals in Pain Management

An epidural is an injection of medication into the space around the spinal cord, known as the epidural space. This type of injection is commonly used for pain relief during childbirth, but it is also employed in various pain management scenarios, including chronic back pain. The medication typically includes a combination of local anesthetics and steroids to reduce inflammation and provide pain relief.

In many cases, it is possible to receive an epidural injection after undergoing herniated disc surgery such as a discectomy or microdiscectomy. However, the decision to administer an epidural post-discectomy depends on several factors and should be made in consultation with your healthcare provider.

Factors Influencing the Decision

• Time since surgery – The timing of the epidural relative to the discectomy is crucial. Most surgeons recommend waiting at least a few weeks to allow for initial healing before considering an epidural.
• Reason for pain – Your doctor will need to determine whether your postoperative pain is related to the surgical site, residual issues from the original condition, or a new problem altogether.
• Overall health and medical history – Your general health, any underlying conditions, and your body’s response to the discectomy will all play a role in determining whether an epidural is appropriate.
• Previous treatments – The effectiveness of other pain management strategies you have tried since the surgery will be taken into account.

Potential Benefits of Post-Discectomy Epidurals

The potential advantages of epidural injections following discectomy surgery include:

• Pain relief – The primary benefit of receiving an epidural after a discectomy is pain relief. For patients experiencing persistent pain following surgery, an epidural can provide significant alleviation of symptoms, allowing for increased mobility and quality of life.
• Reduced inflammation – The steroid component of epidural injections can reduce inflammation in the affected area, which may contribute to pain reduction and faster healing.
• Improved rehabilitation – With better pain control, patients may be able to engage more effectively in physical therapy and rehabilitation exercises, potentially leading to improved long-term outcomes.

Risks and Considerations

While epidurals can be beneficial, they are not without risks. It is important to be aware of potential complications and considerations:

• Infection risk – Any injection carries a small risk of infection. This risk may be slightly higher in patients who have recently undergone surgery.
• Dural puncture – There is a possibility of accidentally puncturing the dura mater (the membrane surrounding the spinal cord), which can lead to severe headaches.
• Nerve damage – Although rare, there is a risk of nerve damage from the needle or the injected medication.
• Bleeding – Patients who take blood thinners or have bleeding disorders may face an increased risk of bleeding at the injection site.
• Medication side effects – The steroids used in epidural injections can have side effects, including temporary blood sugar elevation in diabetic patients.

Alternatives to Post-Discectomy Epidurals 

For patients who are not candidates for epidurals or prefer to explore other options, several alternatives exist:

• Oral pain medications – Various oral medications, including over-the-counter and prescription options, can help patients manage post-discectomy pain.
• Physical therapy – A tailored physical therapy program can strengthen supporting muscles and increase flexibility, potentially reducing pain without additional interventions.
• Acupuncture – Some patients find relief through acupuncture, which may help them manage pain and promote healing.
• Massage therapy – Gentle massage techniques can relax muscles and reduce tension, potentially alleviating some types of postoperative pain.
• TENS units – Transcutaneous Electrical Nerve Stimulation (TENS) devices use low-voltage electrical current to provide pain relief for some patients.

Making the Decision: Consulting with Your Healthcare Provider

The decision to receive an epidural after a discectomy should always be made in close consultation with your healthcare provider. The doctor will consider your individual case, weighing the potential benefits against the risks. Here are some questions to discuss with your doctor:

• How long should I wait after my discectomy before considering an epidural?
• What are the specific risks in my case, given my medical history and the details of my surgery?
• Are there any alternative treatments we should try first?
• How many epidural injections might I need, and how frequently can they be administered?
• What signs or symptoms should prompt me to seek immediate medical attention after an epidural?

Receiving an epidural after a discectomy can be a viable option for pain management in many cases. While it offers potential benefits, such as significant pain relief and reduced inflammation, it is crucial to approach this decision carefully, considering both the potential risks and alternative treatments available. By working closely with your healthcare provider and openly discussing your symptoms, concerns, and treatment goals, you can make an informed decision about whether a post-discectomy epidural is the right choice for your pain management journey. Remember, every patient’s situation is unique, and what works best for one person may not be ideal for another. The key is to find a personalized approach that addresses your specific needs and supports your overall recovery and wellbeing following your surgery.

Even though discectomy surgery is a common and generally quite successful procedure, a hole is frequently left in the outer wall of the disc. In fact, patients with these large holes in their discs are more than twice as likely to reinjure themselves by having what is known as reherniations. These reherniations often require additional surgery or even fusions. Fortunately, there is a new treatment specifically designed to close the large holes that are often left in spinal discs after discectomy surgery. Barricaid is a bone-anchored device proven to reduce reherniations, and 95 percent of Barricaid patients did not undergo a reoperation due to reherniation in a 2-year study time frame. This treatment is done immediately following the discectomy—during the same operation—and does not require any additional incisions or time in the hospital. 

If you have any questions about the Barricaid treatment or how to get access to Barricaid, ask your doctor or contact us today.

For full benefit/risk information, please visit: https://www.barricaid.com/instructions.