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Patients - Your Exam

Pain Management - Epidural Steroid Injection

Epidural steroid injection (ESI) is a minimally invasive procedure that helps relieve pain caused by inflamed spinal nerves. Medicines are delivered to the spinal nerve through the epidural space, the area between the protective covering of the spinal cord and vertebrae. Pain relief may last for several days or even years. The goal is to reduce pain so that patients may resume normal activities and a physical therapy program.


Who is a candidate?
Patients with pain in the neck, arm, low back, or leg (sciatica) may benefit from ESI. Specifically, those with:

  • Spinal stenosis

  • Spondylolysis

  • Herniated disc

  • Degenerative disc

  • Sciatica


What happens during treatment?
A specially trained physician injects the medication as close to the pain site as possible, using fluoroscopy (X-ray) to guide the needle into the precise location. The procedure usually takes 15-30 minutes. Patients can remain awake for the entire process; a local anesthetic numbs the skin before the injection is given.


What happens after treatment?
Most patients can walk around immediately after the procedure. After being monitored for a short time, you usually can leave the office or suite. Typically patients resume full activity the next day. Soreness around the injection site may be relieved by using ice and a mild analgesic (Tylenol).



What are the results?

About 50% of patients experience some pain relief. For those who don't notice any such benefit, additional injections are less likely to help. For those who experience some pain relief, one to two more injections may be performed, usually in 2-week intervals. Some patients experience pain relief for as little as 1 week and others for a year or more. Most importantly, patients may experience enough relief to get moving again, resuming normal activities and/or continuing a physical therapy program.

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