Epidural steroid injections (ESIs) are a common treatment option for many forms of lower back pain and leg pain. An ESI is safe, fast and effective. The medicine is injected into the epidural space or the area that covers the spinal cord where the inflamed nerves are located. If you have intense and difficult to treat pain in your leg or arm from an inflamed spinal nerve, then an ESI may reduce the inflammation and provide pain relief. ESI treatments have been used for decades and are considered an integral part of the treatment of sciatica, arm pain from a pinched nerve and lower back pain.
What is it?
ESIs are minimally-invasive procedures to relieve leg, back, arm, and neck pain caused by inflamed spinal nerves. Nerves become inflamed when the passages narrow as the nerves traverse the spinal canal and foramina. This narrowing can occur as a result of several causes, such as spondylolisthesis (or slipped vertebrae), stenosis, joint cysts, disc herniation, or bone spurs. ESIs have been used for decades and are an effective and safe option for people experiencing pain.
How does it work?
Steroids in epidural injections are believed to have an anti-inflammatory effect that suppresses pain signals from inflamed spinal nerves thereby improving function in the lower back and/or legs. ESI procedures are an outpatient procedure which may be done under moderate sedation or just with local anesthetic. A fluoroscope is a special X-ray machine which allows the doctor to see in real time, the exact placement of the needle and to verify its correct position.
The procedure usually takes no more than five to ten minutes, followed by a brief 15–20-minute recovery before being discharged to your home.
What are the advantages?
Unlike painkillers and oral steroid medications, ESIs deliver medication near the pain source which relieves pain faster than other methods. This form of medication controls chemical inflammation and reduces severe pain. When properly administered, ESIs may help prevent surgery, provide quick and substantial relief, and improve mobility.