Epidural Steroid Injection
Download the Cervical Interlaminar Epidural Steroid Injection treatment handout
Download the Cervical Transforaminal Epidural Steroid Injection treatment handout
Download the Lumbar Interlaminar Epidural Steroid Injection treatment handout
Download the Lumbar Transforaminal Epidural Steroid Injection treatment handout
Chronic back pain and neck pain are the most common causes for years lived with disability throughout the world. There are many non-surgical treatment options available, including epidural steroid injections.
To find out if epidural steroid injections may relieve your pain, call Advanced Spine and Pain at (480) 573-0130 or click here to schedule an appointment.
What is an Epidural Steroid Injection?
An epidural steroid injection, or ESI, is a medical procedure during which a doctor injects a steroid medication into the space surrounding the spinal cord called the epidural space.
Since inflammation around your spine leads to pressure and pain, the steroid works to reduce pain and inflammation in that area. ESIs are commonly used to treat conditions like spinal stenosis, sciatica, and herniated discs. It is an effective way to target the source of the pain and provide relief directly.
What Types of Epidural Steroid Injections Are There?
There are three types of epidural steroid injections: Transforaminal, Caudal, and Interlaminar.
- Transforaminal injections are administered by inserting the needle between your spine and spinal cord to help treat sciatica and other back problems.
- Caudal injections are administered beneath the lumbar for pain focused at the base of your spine.
- Interlaminar injections can be given anywhere on the spine and are particularly effective when treating back, leg, neck, and arm pain.
Epidurals are also named after the region in which they are performed:
- Cervical
- Thoracic
- Lumbar
- Sacral
- Caudal to the area based on where the nerve is pinched
A combination of strong anti-inflammatory medication, such as a steroid and numbing medication, is usually injected into the epidural space surrounding the damaged nerves. These shots can be given anywhere on the spine and are particularly effective when treating back, leg, neck, and arm pain.
What are Epidural Corticosteroid Injections used for?
Epidural injections of steroids are used to reduce inflammation and manage pain caused by a variety of spinal conditions, including herniated discs, degenerative disc disease, arthritis, spinal stenosis, and sciatica.
These injections can be an important part of a comprehensive pain medicine plan that might also include physical therapy, exercise, and other pain medications.
Epidural Steroid Injections for Back Pain Relief
The main goal of epidural corticosteroid injections is to target the chronic pain caused by inflamed and irritated nerves with a medication, such as a steroid. This medication can lower inflammation and decrease pain, allowing people to return to normal daily activities without discomfort.
Does an Epidural Injection Treat Leg Pain?
Irritated nerves can cause pain to radiate or travel down to the legs. If your leg pain is caused by an irritated nerve in the spine, epidural steroid injections can be effective in treating the pain by targeting the source of the pain in your spine. Ask your healthcare provider if lumbar epidural injections might be an option for your pain.
Do Epidural Steroid Injections Work for Axial Low Back Pain?
Axial low back pain is a term usually referring to lower back pain that is dull or achy without any radiating pain down the legs. This type of pain can be caused by many things, including degenerative disc disease, arthritis, or muscle strains.
Since epidural injections are most effective at targeting pain caused by nerve irritation or compression, they might be less effective in treating non-nerve pain like axial low back pain. Ask your healthcare provider if epidural steroid injections could help in your specific case.
How does an Epidural Steroid Injection Work?
An epidural steroid injection works by injecting a steroid medication directly near the area of inflamed spinal nerves to calm inflammation and soothe the pain caused by it.
Steroid medications, especially the type injected into the epidural space, work to reduce pain by blocking the production of some chemicals that cause swelling, pain, and discomfort. By reducing the production of these inflammatory chemicals, steroids help to calm down the inflammation, which in turn reduces swelling, relieves pain, and allows tissues to heal.
Effectiveness of Epidural Steroid Injections
How effective are epidural steroid injections? Pain relief varies based on how severe the underlying issues are, underlying medical conditions, the location, and many other factors that vary from person to person.
Preparation Before an Epidural Steroid Injection
At your pre-procedure appointment or consultation, be sure to tell your doctor if you are pregnant or might become pregnant before the procedure as the specialized imaging (a type of x-ray) used to guide the procedure may not be safe to use.
Also, be sure to list all your medications, even vitamins, herbal supplements, and over-the-counter medicines as some may need to be stopped before the procedure, such as blood thinners.
What to Expect During an Epidural Steroid Injection
On the day of your procedure, you will likely head to a hospital or outpatient clinic. You will change into a medical gown and when the procedure begins you will lie face down on the table.
The doctor may inject a numbing medicine, also known as a local anesthesia, to reduce any discomfort from the injection. The doctor will then place a needle into the epidural space and inject a special liquid called contrast dye that shows up in the x-ray to confirm the needle is in the epidural space and not in blood vessels or other tissues.
Once confirmed, the steroid medication is slowly injected. The needle is then removed and some pressure is placed on the area.
After this, you will move to a chair or bed to observe for any reactions before you head home. The entire procedure may take 5-15 minutes. Remaining very still is important to ensure the injection can be placed precisely where it needs to go.
Epidural Steroid Injections Side Effects
Epidural spinal injections are generally safe procedures, but there are some possible side effects and risk of serious complications to know about, including:
- Low blood pressure
- Severe headache
- Infection (e.g., epidural abscess)
- Allergic reaction
- Bleeding (particularly with blood thinners or bleeding disorders)
- Nerve injury
- Short-term bladder or bowel control issues
- Weakening of the bones and muscles in the area of injection
FAQs for Epidural Steroid Injections
How Painful is an Epidural Steroid Injection?
Due to the local anesthetic, the procedure is typically not painful, but it is possible to experience some momentary pain or pressure during or after the injection.
How Long Do Epidural Injections Last for Back Pain?
Most people experience temporary pain relief after an epidural steroid injection. The pain relief can last anywhere from several weeks to a year or more and varies from person to person.
In some cases, people do not experience pain relief at all after the ESI. Most doctors will limit people to two or three epidural steroid injections per year to reduce potential side effects of the steroid medications.
How Common Are Epidural Steroid Injections for Pain Management?
In the United States alone, healthcare professionals perform around 9 million epidural steroid injections (ESIs) each year. ESIs are considered one of the most effective non-surgical treatments for back pain caused by herniated discs, sciatica, and spinal stenosis.
What Kind of Doctors Perform Epidural Steroid Injections?
Several types of specialists perform epidural steroid injections, including: radiologists, anesthesiologists, neurologists, surgeons, and physiatrists (also called physical medicine and rehabilitation doctors). These injections require specialized training and have to be done in a very careful and precise way.
ASAP physicians are Board Certified specialists and our non-physician providers have years of experience in interventional pain management. We are happy to see patients at any stage, from those with recent low back pain and no treatment, to more complex patients with years of pain and multiple surgeries.
Will I Have to Lie Flat on My Stomach During or After the Procedure?
Generally, yes, you will be lying on your stomach for an epidural steroid injection. This position allows the doctor the best and safest access to your spine.
Remember that the procedure usually takes only 5-15 minutes, so you will not have to be in that position for very long. As soon as the injection is complete, you can likely sit up or lie in a different position.
Can I Eat Before and After My Epidural Steroid Injection?
Each doctor will provide specific instructions regarding eating and drinking on the day of the procedure, depending on their facility. Any sedation requires the driver to not eat or drink eight hours before the procedure.
Are Epidural Steroid Injections Right for You?
An epidural steroid injection involves injecting a strong anti-inflammatory into the space surrounding the spine and its spinal nerves and spinal nerve roots using an epidural needle. This may also include injecting a local anesthetic at the injection site. These injections can provide relatively long-term pain relief compared to oral medications and can be used to treat most areas of the spinal cord such as the lumbar spine (lower back).
Many factors will influence how effective an epidural steroid injection procedure will be for each person. Things like the location, cause of the pain, how severe the condition is, the person's overall health, other treatments (such as physical therapy), and many other factors are the reason that results vary so much from patient to patient.
If you are living with pain, Advanced Spine and Pain is here to help, schedule an appointment with us today.