This procedure is an injection performed to relieve pain in the upper back. To begin this procedure, you either sit or lie down to expose your back. The back is cleaned and sterilized, and a local anesthetic is administered to numb the tissue of the injection site down to the spinal column. The physician uses a fluoroscope (a video x-ray) to guide a needle down to the vertebra that is causing the pain. The needle is carefully pushed into the epidural space, which is the area surrounding the spinal cord. A contrast solution is injected to confirm the needle’s position. Next, the physician injects a steroid-anesthetic mix into the epidural space to help reduce inflammation and reduce pain. After the needle is removed, the injection site may be covered with a small bandage. Extended pain relief usually begins within three to five days of the injection. In some cases it may be necessary to repeat the procedure as many as three times to get the full benefit of the medication. However, many patients get significant relief from only one or two injections. Your PCA physician will work with you to create an individualized treatment plan.