Epidural Steroid Injection

Epidural Steroid Injection (ESI)

An epidural steroid injection is a minimally-invasive approach to treat inflammation of spinal nerves that can cause pain, tingling or a lack of feeling in the back, shoulder, arms, legs or buttocks. Most commonly, this form of treatment is used to relieve pain.

In this technique, the steroidal medications are injected into spinal canal so as to pass down to the inflamed spinal nerve through the epidural space which lies between the covering of the spinal cord and the vertebrae.

An Epidural steroid injection contains a corticosteroid medication along with an anesthetic agent which can reduce the inflammation and pain.

Examples of conditions that may be causing pain, tingling or numbness include:

An orthopedic spine specialist should evaluate your medical history and use imaging to diagnose the cause and severity of your condition. In some cases, physical therapy, NSAIDs or weight loss may be recommended to manage pain.

A person who is experiencing pain, tingling or numbness should see a specialist immediately in order to benefit from the most conservative treatment methods. If an Epidural Steroid Injection is recommended, physical therapy is usually recommended as well. The relief provided by an Epidural Injection is temporary and in most cases should allow a patient to start a physical therapy or exercise program to help control pain going forward.

Location of an ESI

Cervical ESI are typically used to treat pain in the neck area. A Cervical ESI may also be used to treat tingling or pain that travels through the shoulder and arm. Examples of conditions in this area of the spine can include a herniated disc, degenerative disc disease or a bone spur.

Thoracic ESI can treat conditions local to the upper to middle part of the back. Conditions in this area of the back can include thoracic spinal stenosis, herniated disc, scoliosis and trauma.

Lumbar ESI are made in the lower area of the back and are commonly used to treat sciatica. Conditions local to the lumbar region like a herniated disc, stenosis, and osteoarthritis can irritate the spinal nerves of the lower back.

Types of Epidurals

There are 3 types of epidural steroid injections:

• Caudal
• Transforaminal
• Interlaminar

The Transforaminal approach is used more often the Caudal and Interlaminar approaches.

Transforaminal Epidural Steroid Injection

Transforaminal Epidural steroid injection is one of the approaches through which medication can be injected as close as possible to the pain site. The procedure lasts around 15-30 minutes.

During the procedure, you will be lying on your stomach while sedatives will be given to reduce your anxiety. A local anesthetic injection will be given to numb the area of Epidural steroid injection. Then, under the fluoroscopic guidance, your doctor will insert a small sized hollow needle into the epidural space through the neural foramen (bony opening through which spinal nerve exits). A radiopaque dye material is used to reassure proper placement of the needle and flow of the injected medication. Once the needle is in the correct position, the medication is injected into the epidural space followed by which the needle is withdrawn.

Complications are uncommon but there may be minor risks such as infection, bleeding, discomfort at the site where the needle has been inserted.

Epidural Injections in Brooklyn

Patients experiencing numbness, pain, or tingling in their spine, buttocks or legs should exhaust non-operative techniques to treat the condition. An Epidural Steroid Injection or other manner of conservative treatments like physical therapy can be considered after a thorough examination by an orthopedic doctor.

Make an appointment today with one of our pain management specialist to assess and discuss treatment options. The majority of our patients are able to treat or manage their symptoms without surgery.