Epidural steroid injection (ESI) is a minimally invasive procedure to help reduce inflammation and pain caused by spinal nerve root irritation. The spinal nerve can be irritated by compression caused by herniated discs, bone spurs, or narrowing of the spinal canal otherwise known as spinal stenosis. Pain, tingling, numbness, or weakness along the nerve distribution in the arms or legs are typical symptoms and are referred to as radiculopathy. This pain can persist for years if left untreated.
The goal of an epidural steroid injection is to help reduce inflammation along the nerve root. The procedure aims to reduce pain so patients can return to normal activity and participate in a rehabilitation program to strengthen the spine.
What is an Epidural Steroid Injection?
Epidural Steroid injections (ESI) involve injecting a solution of medication in the area between the bone and the protective layer of the spinal nerve called the epidural space. The medications consist of a potent anti-inflammatory called corticosteroids and a numbing agent like lidocaine.
Epidural steroid injections may be performed in the neck (cervical), middle back (thoracic), or lower back (lumbar). The injection is performed through the nerve canals on the side of the spine (transforaminal epidural injection) or through the middle of the spine (interlaminar epidural steroid injection).
What are the indications for this Injection?
Epidural steroid injections are used in patients who suffer from pain in the neck, mid-back, or low back which can radiate to the arms or legs. Patients who have the following conditions are candidates for epidural steroid injections:
- Spinal Stenosis – narrowing of the spinal canal and nerve root canal.
- Herniated Disc – the cushion between bones in the spine, called the intervertebral disc, can bulge or rupture through small tears and cause inflammation in the nearby spinal nerve.
- Degenerative Disc – breakdown or aging of the spinal disc can cause a collapse of the disc, formation of bone spurs, and narrowing of the spinal canal.
- Radiculopathy– irritation of spinal nerves due to nerve canal narrowing, disc bulge, or compression which causes pain to travel into the arms or legs, also known as “sciatica”.
An epidural steroid injection can also be used to determine whether surgery will be successful in patients who have a herniated disc.
Risks Involved with Epidural Steroid Injections
ESI procedures have been performed for many years and are considered safe and effective. Although uncommon, some patients may experience temporary side effects from the steroid medication in the form of facial flushing, insomnia, or irritability.
Serious complications are very rare, which may include an allergic reaction to the medications or contrast dye used, infection, nerve damage, or bleeding. When this procedure is performed properly with fluoroscopic guidance, the risks are minimized. This procedure is typically well tolerated by most patients and provides immediate relief that may last for up to 6 months.
For patients who are unable to obtain long-lasting pain relief or who wish to avoid the use of steroids, natural treatment options exist. These treatments use your own cells, helping with pain, and even may heal your injury. For more information, visit our website to learn more about PRP and cell therapy treatments.