Epidural steroid injections (ESIs) involve a minimally invasive procedure. These injections are used to help relieve back pain along with other forms of pain like back, arm, and neck pain.
ESIs are used when the pain is caused by inflamed nerves in the spine due to disc herniation or spinal stenosis.
Pain relief can last for several days in some cases, and years in others.
The overall goal of epidural steroid injections is to reduce pain to the extent that you can resume your regular activities while also commencing a program of physical therapy.
What Is An ESI (Epidural Steroid Injection)?
A steroid injection contains two parts:
- A corticosteroid like dexamethasone triamcinolone, or methyl-prednisolone
- An anesthetic like lidocaine
These drugs are delivered directly into the epidural space of the spine.
Corticosteroid injections can sometimes soothe inflammation. They can be effective when injected directly into the affected area.
Who Do Epidural Steroid Injections Work For?
Patients with back pain may benefit from ESI.
These injections can also work for neck pain, arm pain, or leg pain (also known as sciatica).
ESIs work for those with these conditions:
- Degenerative disc
- Herniated disc
- Sciatica
- Spinal stenosis
- Spondylolisthesis
ESI can help treat some painful inflammatory conditions.
It can also be used diagnostically to determine if surgery could be beneficial for pain linked to a herniated disc.
Who Performs an ESI?
Epidural steroid injections can be administered by:
- Anesthesiologists
- Neurologists
- Physiatrists (PM&R)
- Radiologists
- Surgeons
What Happens Before The Procedure?
The doctor performing the procedure will review your medical history along with any previous imaging studies. This will help him to plan the most suitable approach for these injections. Have any questions prepared and ask them at this point.
If you take blood thinning medication, you might need to stop taking this in the days before your ESI. Discuss this with your healthcare provider and the doctor performing the injection.
ESIs are normally carried out in an outpatient setting with x-ray fluoroscopy.
What Happens During The Procedure?
You then need to sign consent forms and to list all medications you are currently taking, as well as outlining any allergies to medication you have.
The procedure will last from 15 to 45 minutes. You’ll then need to factor in a recovery period.
The object is to have the medication injected as close as possible to the painful nerve.
You will lie on an x-ray table. The treatment area is then numbed with local anesthetic. This ensures any discomfort felt during the procedure is mild and minimal. Some treatment centers might offer an oral sedative in low doses.
The doctor will then insert a hollow needle through your skin and in between the vertebrae in the epidural space. If you feel anything, it will be a sensation of pressure rather than pain.
With a cervical ESI, the needle enters the side of the neck. Lumbar ESIs see the needle entry site just off the midline of the back while caudal ESIs involve an injection into the tailbone.
Once the needle is positioned according to the type of injection being administered, the doctor injects both corticosteroid medications and anesthetic into the epidural space surrounding your nerve roots.
After ESI Treatment
You should find you can walk about immediately after the procedure. You should be free to leave the center after a short period of observation.
Resuming normal activity should be fine the following day. Expect some soreness around the site of the injection. Try using ice or Tylenol to relieve this.
Make a follow-up appointment with the treating physician to establish how well it went and where to go from here.
Results of ESI
If you only experience mild pain relief, you can arrange for one or two follow-up injections to achieve a fuller effect.
Some patients find pain relief lasts a few years while others experience years of pain relief.
Risks of Epidural Steroid Injections
ESI has few meaningful risks and it’s viewed as an appropriate nonsurgical treatment for some patients.
Potential risks include spinal headache, infection, bleeding, allergic reaction, and possible nerve damage or even paralysis. This latter is extremely rare.
You might also notice some mild side effects from corticosteroids including weight gain, hot flashes, water retention, mood swings, and insomnia.
What To Do Next
If your back pain is so severe that you don’t know where to turn, you should consider speaking with a pain specialist in Arizona.
Fill in this quick online form or call us today at (480) 409-7703 to schedule an appointment.
