An epidural steroid injection is a spinal procedure in which a steroid and usually an anaesthetic are injected in the spinal region called the epidural space. The epidural space is a specific zone where the nerves leave the spinal column. The nerves, spinal fluid, and spinal cord are enclosed within a membrane sack called the dura. This “space” can become narrowed due to disc herniation / prolapse, bone overgrowth and general spinal degenerative changes.

A peripheral nerve block is an injection of local anaesthetic & steroid around a nerve that supplies a particular region / muscle. Peripheral nerves supply sensation to a small, defined area of the skin and the underlying tissue. Sometimes these nerve are well formed structures (e.g. Median nerve at the wrist) other times they are less formed and a group of fibres maybe involved (e.g. trans-abdominal plexus block) capture.

Epidurolysis, also known as the RACZ Procedure is a technique used to dissolve some of the scar tissue from around entrapped nerves in the epidural space of spine. There are number of ways that this can be undertaken.

A small volume of platelet rich plasma (PRP) can contain a high concentration of growth factors and cytokines. PRP has a dual role to firstly create a healing environment and secondly reduce inflammation.

By using PRP it can reduce peripheral nerves supply sensation to a small, defined area of the skin and the underlying tissue including tendons and ligaments

Ultrasound guidance or X-ray can be used to increase the accuracy of this injection in order to treat the painful area.

Epimed International has developed a line of catheters to be used specifically in this epidural space to direct medications to the inflamed nerve. Epimed catheters are made with a flexible rounded tip designed to be safely navigated through sensitive tissues.