Even though the terms spinal block and epidural serve different purposes, many people confuse and use the terms interchangeably. Both are ideal pain management solutions, especially in childbirth and C-sections, but each works differently and in specific conditions. Understanding the difference between a spinal block and an epidural is essential to making an informed decision about your pain management options.
This blog discusses both options to help you make the right choice.
Table of Contents
What is a Spinal Block?
A spinal block is a spinal anaesthetic that temporarily causes loss of feeling in the lower body. The level at which desensitisation begins depends on the spinal level at which the drug is administered. It is also called regional anaesthesia, spinal anaesthesia, saddle anaesthesia, or subarachnoid block.
How is it Administered?
Before we dig deeper into the spinal injection procedure, let’s understand the structure of the spinal cord.
Consider the spinal column, a tubelike structure through which spinal nerves emerge to supply the body. It is a connection between the brain and the lower body.
Three layers cover our spinal cord – dura mater, arachnoid mater, and pia mater. A subarachnoid space, i.e., a space between the arachnoid and pia mater, is filled with Cerebrospinal fluid (CSF). Your doctor will inject spinal block into this space.
A fast-acting local spinal anaesthetic is injected using a thin needle that passes the tissues and reaches the subarachnoid space, typically in the lower back or lumbar region. After administration, the anaesthetic drug works quickly to numb the lower part of the body – a condition of no feeling and no pain.
Patient Position
You will either be sitting or lying on your side and may have to arch your back for smooth administration. It takes only a few minutes to complete.
How Does it Feel?
Whilst the needle is injected, you may feel pain like a mosquito bite. Analgesics may also be injected together with an anaesthetic to relieve pain.
When Is It Commonly Used?
A spinal block is usually employed when complete pain relief is needed. For example:
- During C-sections
- Pelvic or lower body surgeries
- Emergency surgeries
Spinal Block Duration and Onset of Relief
Once the drug is administered, relief begins in 5-10 minutes and lasts for 2-4 hours.
Advantages of Spinal Block
- Usually preferred in critical emergency surgeries when fast pain relief is important.
- Completely numbs the lower body—you will not feel any sensations.
- A single-dose procedure—no need for continuous monitoring or administration.
- Fewer side effects than numbing the whole body, i.e., general anaesthesia.
- Higher satisfaction rate among women during childbirth.
Spinal Anesthesia Side Effects
- Not suitable for prolonged pain relief, as it is effective for short durations.
- The dosage cannot be changed after administration.
- Not an ideal option for gradual or ongoing pain relief that is required during labour.
- You may experience low blood pressure, headache, difficulty urinating, or nausea.
- You cannot move your lower body.
Recovery
You will lie straight on your back for several hours until complete recovery. It is usually quicker than an epidural, depending on the dosage. Staff will monitor your vitals until you gain full control over your movement.
What Is an Epidural?
An epidural is an analgesic that provides regional pain relief, particularly in the lower part of the body.
How Does an Epidural Work?
Contrary to the spinal block, it does not provide complete pain relief; rather, it lessens the pain intensity and allows some movement and sensations. Doctors prefer epidural analgesia for labour.
How is it Administered?
The practitioner inserts a thin, flexible catheter into the epidural space, which is a space lining the dura mater (the first layer covering the spinal cord). The dose is adjustable and allows continuous or periodic administration during labour.
When Is It Commonly Used?
An epidural is mostly preferred in:
- Labour and vaginal childbirth
- Chronic lower back or leg pain
- Pain management after surgery
Duration and Onset of Relief
It takes 10-20 minutes to start working. The duration varies with the individual needs, ranging from hours to even days.
Benefits of Epidural
- Your doctor can adjust the dosage
- Best for prolonged pain relief, for instance, during labour
- Permits some movement
Limitations of an Epidural
- Slow-acting—not ideal for emergency procedures
- Catheter placement is a little more invasive than a spinal block
- You may experience itching, low blood pressure or incomplete pain relief in some areas
- Close supervision is required whilst the administration
Recovery
In case of prolonged pain relief medication, you’ll be asked to rest for a few days after the injection to let it settle. But, if used for childbirth, you will recover within 4 hours.
Let’s discuss some key differences between spinal blocks and epidurals.
Understanding the Difference Between a Spinal Block and an Epidural
Spinal blocks and epidurals are used to relieve pain in back and spinal conditions or childbirth. Both mainly differ in their level of pain relief and mode of action.
A spinal block is an anaesthetic that numbs the body, whilst an epidural is an analgesic that lessens pain. As for the level of pain relief, the former totally relieves the pain, whilst the latter provides partial pain relief.
In a comparative study, 79.2% of patients who received a spinal block reported satisfaction, compared to 70.5% of those who received an epidural.
Both serve as credible options for pain management and for administering medications during chronic pain conditions.
Advantages of an Epidural over Spinal Block
If you are giving birth for the first time, your doctor may employ an epidural since first births last longer, from 12-18 hours, and a spinal block only works for 4 hours. Epidurals provide prolonged pain relief.
Advantages of a Spinal Block over an Epidural
If you have complications during birth and may require a C-section, a spinal block is used. Similarly, lower body surgeries or emergency procedures are preferred.
Which One Is Right for You?
The choice between both procedures depends on your condition and overall medical history. Your doctor will review your health history, allergies, and risk factors to make the safest choice.
Choose the Best Option with Dr. Yasser Mehrez
Now that we have discussed the difference between a spinal block and an epidural, it is time to consult an expert to help you make your choice. Every patient is unique, and so is their pain. That’s why it’s critical to have an experienced pain management expert like Dr. Yasser Mehrez help with this decision. He evaluates your needs and chooses the best option for you.
Dr. Yasser Mehrez also offers fluoroscopic guided interventions, using advanced real-time imaging to practice with precision. This technology allows for precise medication placement directly into the spinal space, maximising relief whilst minimising risks.
By targeting the exact source of discomfort, fluoroscopic-guided injections ensure more effective results and faster recovery.
Schedule an appointment today to discuss your pain-management options!
