Epidural Steroid Injections

Epidural Steroid Injections (ESIs) are a frequently used treatment at the Spine & Nerve Centers for chronic pain syndromes. ESIs are often used to treat radicular pain, which is pain that radiates from the spine down an irritated spinal nerve root. This can cause sharp pains to shoot from the lower back into one or both legs, or from the neck into one or both arms. Epidural injections can also be used to treat nerve compression in the neck and lower back.


Typically, Epidural Steroid Injections are performed in a doctor’s office or a hospital. The patient lies face down on a table or bed, and the skin will be injected with an anesthetic to numb it. Using live X-ray video called fluoroscopy, the doctor will insert a needle through the skin and guide it into the epidural space, where the irritated nerve roots are located. The doctor injects a solution that contains a long-lasting steroid and may also use a local anesthetic. The ESI is designed to reduce the inflammation and irritation and interrupt the pain signal transmission. The epidural injection is usually not painful because of the numbing anesthetic, but there may be mild tenderness for a few days after the injection. As with all therapies, the amount of pain relief will vary from person to person. Some patients have relief that lasts for years while others may only find short-term relief or no improvement.


Although ESIs are considered relatively safe and are one of the most commonly performed procedures in the world for patients who suffer from back and neck pain, there are risks associated with the procedure. Among the risks associated with this procedure are headache, nausea, vomiting, bleeding, infection, and nerve damage. The other risks of ESIs may be directly related to the medications injected, so all patients should discuss this with their doctor prior to the procedure.

Patients should consult with their pain physician before receiving the procedure if they:

  • have an allergy to any anesthetic
  • are on blood-thinning medications
  • have an active infection
  • are pregnant

Check with your physician to see if the procedure is right for you.

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