Epidural Steroid Injections

An epidural steroid injection (ESI) delivers anti-inflammatory medication directly to the area around irritated spinal nerves. Steroids are powerful anti-inflammatory medications. When placed near the source of pain, they can calm inflammation that puts pressure on nerves, which may help reduce pain and improve your ability to move.

A numbing medication (local anesthetic) is often included with the steroid. This may provide short-term relief while the steroid begins to work over the next several days.

At Spine & Orthopedic Center, epidural steroid injections are one of the most common nonsurgical treatments we offer. They are often part of a broader treatment plan that may include physical therapy, medication, and other pain management options.

Conditions Epidural Injections May Help Treat

Epidural steroid injections are most often recommended for pain caused by irritated or compressed spinal nerves. Conditions they may help manage include:

• Herniated disc
• Bulging disc
• Sciatica
• Spinal stenosis
• Pinched nerve
• Degenerative disc disease
• Radiculopathy (pain, numbness, or tingling that travels into the arms or legs)
• Chronic low back and neck pain

Your physician will review your symptoms, imaging, and treatment history to determine whether an epidural injection may be appropriate for you.

Types of Epidural Steroid Injections

Epidural injections can be given at different levels of the spine and through different approaches. Your physician will recommend the option that best fits the location and cause of your pain.

By Area of the Spine

• Lumbar epidural injections: Given in the lower back. Often used for low back pain, leg pain, and sciatica.
• Thoracic epidural injections: Given in the upper and mid back. Used for pain in the chest wall or upper back area.
• Cervical epidural injections: Given in the neck. Often used for neck pain and pain that travels into the shoulders or arms.

By Approach

Interlaminar Epidural Injections: The needle is guided between two vertebrae, from the back of the spine, into the epidural space. This approach spreads medication over a wider area and may be used when pain affects both sides of the body or several nerve levels.

Transforaminal Epidural Injections: The needle is guided from the side of the spine, toward the opening where a nerve root exits (called the foramen). This approach places medication close to a specific irritated nerve and is often used for pain on one side of the body.

Caudal Epidural Injections: The medication is delivered through a small natural opening near the tailbone. This approach may be used for lower back and leg pain, especially in patients who have had previous spine surgery.

Selective Nerve Root Blocks: A small amount of medication is placed around a single nerve root. Along with helping to relieve pain, this injection can help your physician pinpoint which nerve is causing your symptoms.

Are You a Candidate for an Epidural Injection?

An epidural steroid injection may be an option if:

• You have back, neck, arm, or leg pain caused by an irritated spinal nerve
• Your pain has not improved enough with rest, medication, or physical therapy
• You would like to explore nonsurgical options before considering surgery

Your physician will complete a thorough evaluation to determine whether an epidural injection is right for you.

What to Expect During Your Procedure

Epidural steroid injections are performed as an outpatient procedure, and most patients go home the same day. The injection itself usually takes only a few minutes.

The skin is cleaned and numbed. Using X-ray guidance (fluoroscopy), your physician carefully guides a thin needle to the targeted area. A contrast dye may be used to confirm placement before the medication is delivered. Sedation may be available for patient comfort.

Before your appointment, let your care team know about any medications you take, especially blood thinners. If you receive sedation, plan to have someone drive you home.

Recovery and What to Expect Afterward

Most patients return to normal activities within a day. You may notice some soreness at the injection site for a day or two.

The numbing medication may provide relief right away, but it wears off within a few hours. The steroid typically begins working within a few days. How long relief lasts varies from patient to patient. Your physician will talk with you about next steps, including whether additional injections or physical therapy may help.

Potential Risks and Side Effects

Epidural steroid injections are commonly performed and generally well tolerated. Temporary side effects may include soreness at the injection site, facial flushing, trouble sleeping, or a short-term rise in blood sugar. Less common risks include infection, bleeding, headache, or nerve irritation. Your physician will review the risks and benefits with you before your procedure.

Epidural Injection Physicians

Epidural steroid injections at Spine & Orthopedic Center are performed by fellowship-trained spine surgeon Dr. Ashish Sahai and fellowship-trained pain management physician Dr. Kristy Fisher. 

Related Treatments

• Radiofrequency Neuroablation
• Facet Joint Injections
• Spinal Cord Stimulation
• Peripheral Nerve Stimulation
• mild® Procedure
• Intracept® Procedure
• Kyphoplasty
• Physical Therapy