FAQ’s on Epidural Steroid Injection (ESI)


An Epidural Steroid Injection is a therapeutic injection of a local anesthetic along with a strong anti-inflammatory medication called a corticosteroid that is injected into the spinal canal in the space around the area of the spinal cord and nerve roots called the epidural space. The local anesthetic will give immediate relief but the corticosteroid can take longer, sometimes even two or three treatments before the full benefit is felt.

What can be gained from Epidural Steroid Injections?

The purpose of the Epidural Steroid Injection is to provide the patient with a effective level of Pain Relief that will help them return to a more active, normal lifestyle, and a general higher standard of living by reducing pain levels.

Another goal of the Epidural Steroid Injection is to delay, or even prevent, the need for surgery.

How are Epidural Steroid Injections procedure performed?

An MRI and/or CT scan will tell the physician where the exact location of the injection site is located with real-time imaging. The physician will then perform the procedure with the aid of a diagnostic X-ray machine called a fluoroscope to help guide the precise placement of the needle during the injection procedure. The needle will be inserted into the epidural space of the spinal canal and the medications are injected into this space.

Often the patient will be sedated to help them relax during the procedure and to minimize risk that could be caused by patient movement during the injection. The procedure takes about ½ hour and the patient will be observed afterwards for side effects. Often the patient will need someone to accompany them to drive them home after the procedure due to the sedatives.

How long do the Epidural Steroid Injections last?

Typically the patient will experience relief from the injections for two to three weeks. However the long term benefits are not well known. The injections may only be administered three times in a twelve month period, typical they will be given every two to three months and no more than three injections will be given in any one location. Multiple injection locations may be administered during the procedure.

What are the risks or side effects of Epidural Steroid Injections?

Side effects may include tenderness and/or bruising in the injection site, nausea, dizziness, headache, pain and discomfort at the site, infection, bleeding, nerve root injury, or in rare cases meningitis. People with diabetes or immune disorders are at higher risk of side effects. Persons with mental health issues may be at risk as well.

ESI is a low risk generally safe therapeutic treatment for symptoms of pain, possible side effects may be:

  • nausea, dizziness, or headache
  • allergic reaction to the medication
  • increased pain down the patient’s leg as a result of nerve root damage
  • hematoma(bleeding) around the site of injection

What conditions are treatable with Epidural Steroid Injections?

Typically these injections are given to persons suffering from a conditions affecting the lower spine, hips, and legs with pain symptoms radiating from the lower spine.

The most common condition is called lumbar spinal stenosis. The injections are intended to relieve leg pain and symptoms of pain caused by the conditions or injury, rather than solely only general back pain.

How successful are Epidural Steroid Injections for the relief of pain?

 

The effectiveness of Epidural Steroid Injections may vary from person to person, but typically the patient can expect to have some level of relief from the procedure.

Patients who seek therapeutic treatment for pain symptoms early in their condition will reap the highest success level.

If the patient has a chronic condition or is more advanced with the symptoms and complications of severe injury or debilitation, the outcome may not be as effective or successful.