Epidural Steroid Injections
Epidural steroid injections (ESI) are performed to reduce lumbar-related leg pain or cervical-related neck and arm pain by reducing inflammation in the spinal nerve channels exiting the spine. The epidural space provides a cushioning for the nerves and spinal cord. A steroid injection into this location acts as a powerful anti-inflammatory agent that can reduce pain improve function.
The steroid works on the spinal nerves by eliminating the proteins that cause swelling. This effect can last briefly or even for years. During the period of relief, some patients are able to improve their spinal condition with physical therapy and exercise.
Am I a candidate for ESI?
You may benefit from ESI if you doctor has diagnosed you with any of the follow conditions:
- Spinal stenosis
- Herniated spinal disc
- Degenerated spinal disc
ESI may also help patients in physical therapy when pain interferes with rehabilitation exercises.
What is the procedure for getting an epidural steroid injection (ESI)?
- Depending upon your individual condition, the delivery location of the injection may be interlaminar, caudal or transforaminal. These are different places related to spinal anatomy.
- Interlaminar and caudal injections cover a wide area over several spinal segments. Transforaminal injections are intended for concentrated delivery to one specific area, usually a point where an affected nerve emerges from the spine.
- Contrast dye is used to track the progression of the medication.
- Normally, the steroid solution has a local anesthetic added to it for your comfort and temporary pain relief.
- Your doctor uses a fluoroscope to exactly guide the needle placement.
- The procedure is done in the physician’s office, and you will be able to leave shortly after. Most patients can walk immediately after the procedure. To be safe, it is best to have someone drive you home.
- Normal activity can be resumed as soon as the next day.
- The procedure is relatively painless and uses only a skin anesthetic.
- Any temporary sensitivity around the injection site can be relieved with an ice pack and a mild analgesic.
Is ESI safe?
These injections have been in practice for decades and have worked well for back/leg pain and neck/arm pain when your condition has been correctly diagnosed. As is true with any medication, some side effects can occur, but are rare. ESIs have a long track record of being well tolerated.