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Epidural Steroid Injections

Epidural steroid injections, or ESIs, are a minimally invasive treatment that has been used for decades to relieve low back (lumbar) and leg pain (sciatica). They have been shown to be effective for pain in the neck (cervical) and mid-spine (thoracic) as well.  ESIs are often effective in relieving the chronic pain.

Comprised of cortisone and a local anesthetic or saline solution, ESIs work by reducing inflammation and flushing out irritants that cause swelling and pain. Medications are delivered directly to the source of the pain rather than dispersing it throughout the body, as oral painkillers and steroids do. They are injected into the epidural space, the area outside of the dura (a membrane covering the brain and spinal cord).

There are different types of ESIs. Interlaminar ESIs require inserting the needle between the lamina, a small section of bone that covers the spinal cord, of two vertebrae. The medication enters the epidural space in the midline and from there is able to reach the nerve roots on either side of the spine. Transforaminal ESIs place medicine through the neural foramen, the exit point for individual nerve roots, and in to the epidural space. Caudal ESIs administer medicine through the sacral hiatus, the lowest entry point in the sacrum, to bathe the lumbosacral region with anti-inflammatory medicine.

What to Expect:

  • The procedure will be performed in an operation room with conscious sedation.

  • The procedure may take up to two to three weeks to take full effect.

  • Your symptoms may feel worse in the first few days before it gets better.

  • After the procedure, patients will take the rest of the day off.

  • You will be able to resume normal daily activities the next day.