An epidural steroid injection (ESI) is a minimally invasive procedure that can help relieve back, and leg pain caused by inflamed spinal nerves due to spinal stenosis or disc herniation.
A steroid and anesthetic mediation is delivered to a fat-filled area that lies between the bone (facets) and the protective sac of spinal nerves, this is known as the epidural space. The steroid is administered to reduce the inflammation of the disc and reduce any pressure the disc is applying to the surrounding nerves that is causing your pain. The steroid may take anywhere from 5-8 days to take affect and give pain relief. The anesthetic is administered to give a quicker onset of pain relief. The anesthetic is only designed to provide temporary relief during the time of the injection, and will only last 8-24 hours.
This injection is not designed to cure your pain. Pain relief may last for several days or even years. The goal is to reduce pain so that you may resume normal activities and a physical therapy program.
Sedation is provided for patient comfort. For the procedure to be as safe as possible, an x-ray technique known as fluoroscopy is used to position the needle accurately.
Patients with pain in low back, or leg may benefit from ESI. Specifically, those with the following conditions:
- Spinal stenosis: A narrowing of the spinal canal and nerve root canal can cause back and leg pain, especially when walking.
- Spondylolisthesis: A weakness or fracture between the upper and lower facets of a vertebra. If the vertebra slips forward, it can compress the nerve roots causing pain.
- Herniated disc: The gel-like material within the disc can bulge or rupture through a weak area in the surrounding wall (annulus). Irritation, pain, and swelling occur when this material squeezes out and comes in contact with a spinal nerve.
- Degenerative disc: A breakdown or aging of the intervertebral disc causing collapse of the disc space, tears in the annulus, and growth of bone spurs.
- Sciatica: Pain that travels along the sciatic nerve in the buttocks and down the legs. It is usually caused by compression of the 5th lumbar or 1st sacral spinal nerve.
This injection is offered for the treatment of radiating neck pain as well. Associated Pain Specialists, limits this procedure to the lower back region, and cervical epidurals will require a specialty referral that your provider at APS can submit for you.