An Epidural Steroid Injection (ESI) is commonly used to diagnose and treat pain which is thought to be originating from the spinal column. It has been a safe and proven treatment for pain since the 1950’s.
Disc protrusions, spinal arthritis, and overgrowth of bones and ligaments can lead pinching of nerves in the spine. This can happen from overuse, aging (wear-and-tear), or be the result of an injury or surgery. When the spinal canal becomes compromised, the spine or the spinal nerves can suffer inflammation which may cause pain. Like the name sounds, an epidural steroid injection is an anti-inflammatory medication that is injected with the intention of decreasing the inflammation that is causing pain. A mix of steroid and numbing local anesthetic can be placed onto into specific nerves or groups of nerves to diagnose the cause or location of pain. This can help guide future treatments including proper exercise, future injections or surgery.
There are many different types of corticosteroids used in epidural injections. There are also many different techniques and ways of getting the medication to the indented target in the neck, mid-back or low back. Transforaminal injections target specific levels and side where the nerve(s) exits the spine, whereas interlaminar or translaminar injections are targeted more broadly at the spinal canal. With any of these injections, X-ray imaging and injection of very low-dose contrast are typically used to help guide the injection as long as the patient doesn’t have allergies, and have been shown to improve accuracy and outcome.
Determining if a patient would benefit from an epidural steroid requires a thorough examination and review of history by a licensed pain management specialist. In addition to medical history and physical examination, xrays, MRIs and CT scans are often used to help discover the cause of the pain.
Like any procedure or medication, there are some risks from an epidural steroid injection. Complications such as bleeding and infection are luckily extremely rare. Patients may experience temporary weakness lasting a few hours as a result of the numbing medication that is injected with the steroid.
If you suspect or have been told that your pain may be originating from your spine, you should talk to your licensed pain management provider about diagnostic and treatment options, including epidural steroid injections.
- Russell Kinder, MD ( Board Ceritfied - Pain Medicine & Anesthesiology )