Epidural Steroid Injections

What is a Epidural Steroid Injection?

Epidural Steroid Injections are a type of treatment that have been used for years. Epidural Steroid Injections (ESI’s) are commonly used to treat herniated discs, sciatica, and several other causes of back pain.  

These injections deliver steroid directly to the epidural region of the patient’s spine.  

It is important to note the injection is never administered into the spinal cord. The steroid has an anti-inflammatory affect, reducing inflammation and pressure on the irritated nerves.  

The nerves in the epidural region travel to the mid back and along the body’s ribs. Any type of inflammation can be caused by damaged discs or any damage done to the bony structure of the spine, and the injection shrinks this inflammation. 

The nerves within the region are then bathed in the steroid and anesthetic, inhibiting the pain from being able to radiate. Depending on the source of the pain, there are three locations for the injection: cervical, thoracic, and lumbar. Your pain management physician will be able to determine the best location approach for your ESI. 

The cervical region is located roughly in the top third of the spine, thoracic in the middle third of the spine, and the lumbar in roughly the lower third. The source of the back pain will determine the injection site for the ESI. Beneficially to the patient, the injection delivers concentrated medicine directly to the source of the pain. 

The physician giving the injection may use additional fluid(s) with the steroid, such as anesthetic and a saline solution to help flush out any additional sources of pain in the epidural region. 

There are three types of ESI’s: 

• Caudal
• Interlaminar
• Transforaminal

Caudal Epidural Steroid Injections  

A caudal ESI is the simplest steroid injection and administered into the lowest portion of the epidural space. This method is best to treat widespread or diffused pain. It is done through the bony opening of your tailbone, and is considered the safest method.

Interlaminar Epidural Steroid Injections

An interlaminar injection delivers the anesthetic and steroid medication between the laminar of two adjacent vertebrae. The physician administering the injection takes a central approach to the bones of the adjoining spinal segments. This method is commonly used to treat back pain due to herniated discs and spinal stenosis. It is optimal for relieving radicular pain. 

Transforaminal Epidural Steroid Injections  

The transforaminal epidural steroid injection (also known as TFESI) is also injected into the epidural space, but the medical professional delivering the injection takes a lateral approach to the spine. The TFESI is injected where the nerves from the spine move towards the rest of the body. This injection also offers diagnostic ability because it can be directed at specific nerve roots.  

Epidural steroid injections provide several beneficial options to patients. Beyond pain relief, ESI’s provide freedom for patients in their pain management journeys. Patients who prefer not to use oral opioid medications (or are unable to tolerate the physical side effects of oral medications) are able to utilize injections to manage their pain.  

An ESI injection also provides the patient with time. Some patients may want to pursue physical therapy but are in too much pain to even begin. Other patients may have a back surgery planned but are still in pain. These patients should not have to suffer in the interim while waiting to pursue their future health plans.   

Recovery from Epidural Steroid Injections 

The procedure for an epidural steroid injection may take 15-30 minutes. The patient will be monitored for a short period after the injection and is able to go home. Patients will require a driver to take them home. Patients are encouraged to only engage in light activity for a few days after their procedure because some soreness at the injection site is to be expected. Some patients may begin experiencing pain relief immediately, with the full benefit of the ESI taking affect between 1-4 weeks. 

How To Get Started

If you would like more information about the Epidural Steroid Injection, our back pain services or other pain management therapies we offer, please call Pain and Spine Specialists and speak to our dedicated team to improve the quality of your life. You can call Maryland Phones, Pennsylvania Phones, or Virginia Location and schedule an appointment today.