Epidural Steroid Injections
The epidural space is comprised of fat and blood vessels, and it surrounds the dural sac. In turn, the dural sac encircles the spinal cord and nerve roots. An epidural steroid injection is a type of therapeutic injection that places steroid medicine and a local anesthetic into the epidural space where it coats parts of the spinal cord and nerve roots. These injections can treat pain in a large region of the body, helping to minimize inflammation and thereby providing pain relief for patients experiencing chronic pain related to spinal stenosis and/or a disc herniation with associated neck (cervical), back (thoracic / lumbar) and extremity pain.
What is an Epidural Steroid Injection?
An epidural steroid injection involves the administration of local anesthetic (numbing medication) and steroid solution into the epidural space. This is performed under fluoroscopy (X-ray), in order to deliver the drug to the precise location. There are two types of epidural steroid injections:
- Intra-laminar approach (more central approach, between the bones of the spine)
- Trans-foraminal approach (through the nerve root opening)
What to expect during an Epidural Steroid Injection procedure
Your pain specialist will have you lay on your stomach while they numb the surrounding skin nearest the pain site with a local anesthetic. With fluoroscopic guidance, a thin needle is guided into your back and into the epidural space, closest to the site of the pain, where medication is administered. Usually, the procedure takes less than 10 minutes, and you can go home the same day after being monitored in the recovery room for 30 minutes.
What to expect after an Epidural Steroid Injection procedure
Some patients report pain relief within 30 minutes after the injection, but pain may return a few hours later when the anesthetic wears off. Longer term relief usually begins in 2 to 3 days, once the medication combined with the anesthetic begins to work.
Pain relief for each patient varies, for some the relief lasts weeks, for others, years. If the pain returns, you can discuss having another ESI with your healthcare provider. The rule of thumb is no more than 3 ESI’s within a 12-month period.
You can continue your regular diet and medications after the procedure, but don’t drive or do any rigorous activity for 24 hours after the procedure.