Epidural steroid injections (ESI) are performed to place anti-inflammatory medication (steroid) and local anesthetic in the epidural space to target irritated nerves and relieve pain. They are most commonly performed for patients with spine pain and radiating pain into either the arms or legs.
Injections are performed under X-ray guidance. If an initial series of three injections fails to provide lasting relief, your physician will discuss options for altering the treatment plan.
There are three different ways to do an epidural steroid injection and your physician will choose the route that offers the best chance of relieving your pain based on several factors.
The Caudal approach involves an injection at the base of your spine near your tail bone. An advantage of this approach is that it can be done easily even if you have had major spine surgery.
The Interlaminar approach can be performed at all levels of the spine from the low- back to the neck. This approach may not be possible if you have had spine surgery in the injection area. An advantage of this approach is that medication may be delivered closer to the area of pain.
The Transforaminal approach involves placement of the needle into the area where your spinal nerve exits the spine. It can be done throughout the spine, but is done most frequently in the low-back. This approach can be used in areas of prior surgery, and may deliver medication most accurately to the area of nerve irritation.
Epidural steroid injections of any approach usually take about 10 to 15 minutes total. Your procedure may take slightly longer if your physician recommends an approach at two different levels of your spine.
Some patients feel improvement right away, while others have a temporary sensation of pressure at the site. The main benefit from the steroid usually takes effect in 48-96 hours.
Relief from an Epidural steroid injections or series of ESIs varies from person to person. Usually one can expect pain relief to last for 1 to 6 months, and the average is approximately two months.
Also called ESIs, epidural steroid injections are a method of treating spine pain that extends into arms and/or legs.