At Vertex Pain Physicians, we specialize in offering epidural steroid injections (ESIs) to effectively manage and reduce pain caused by inflammation of the spinal nerves. This minimally invasive procedure is designed to provide relief from conditions such as herniated discs, spinal stenosis, sciatica, and other spine-related disorders.
What is an Epidural Steroid Injection?
An epidural steroid injection (ESI) is a minimally invasive injection where anti-inflammatory steroid medication is directly delivered directly into the epidural space around your spinal cord. This medication works by reducing inflammation and swelling around the spinal nerves.
We use ESIs to treat pain in the neck, arms, back, or legs, especially when nerve root irritation or inflammation is involved. Common conditions treated with ESIs include:
- Post-Laminectomy Syndrome
- Degenerative disc disease
- Spondylolisthesis
- Radiculopathy
- Scoliosis
- Chronic Post-Surgical Pain Syndrome
- Post-herpetic neuralgia or acute herpes zoster
- Herniated discs
- Ruptured discs
- Spinal stenosis
- Bulging discs
- Sciatica
By targeting the inflammation directly, ESIs can help relieve pain, allowing you to participate in physical therapy, regain mobility, and improve overall function.
Types of Epidural Steroid Injections
There are three main types of epidural steroid injections, each designed to treat specific areas and pain patterns. Here’s a breakdown of each one:
Interlaminar Epidural Steroid Injection
The Interlaminar ESI delivers medication between the vertebrae, covering a broad area of the spine. This is helpful for patients with widespread inflammation or pain affecting multiple nerve root levels.
Best for conditions like:
- Neck pain radiating to the arms or hands
- Back pain radiating down both legs
- Degenerative disc disease
- Spinal stenosis affecting multiple nerve roots
- Generalized lower back pain
Transforaminal Epidural Steroid Injection
The Transforaminal ESI targets a specific nerve root, delivering medication directly to the area where the pain originates. This allows more precise delivery of the steroid to the area that needs it most. This type of epidural injection is very effective if the pain is largely one-sided. This is effective for conditions like sciatica or radiculopathy.
Best for conditions like:
- Unilateral radiculopathy (pain running down one leg)
- Pinched nerves from herniated discs
- Radiculopathy in the neck or lower back
- Nerve root compression from bone spurs or spondylolisthesis
Caudal Epidural Steroid Injection
The Caudal ESI involves injecting medication at the base of the spine through the sacral hiatus. This injection is ideal for pain in the lower back and legs, especially when the lower lumbar or sacral nerve roots are affected. This injection is particularly helpful to target low back pain in patients who have previous lumbar surgery or when other epidural steroid injections are not effective.
Best for conditions like:
- Pain running down both legs
- Chronic lower back pain
- Post-surgical scarring or adhesions
- Spinal stenosis in the lower lumbar region
How We Choose the Right Type of ESI for You
The type of epidural steroid injection we recommend depends on several factors:
- Where your pain is: Whether it’s localized or radiates to other areas
- The condition you’re suffering: For example, sciatica or degenerative disc disease
- Your medical history: Previous treatments, surgeries, or how you responded to other therapies
- The severity of your symptoms: The intensity and duration of your pain
We use advanced imaging techniques, such as fluoroscopy (real-time X-Ray), to guide the needle into the correct position. This ensures the delivered medication reaches the intended target area in a precise and effective manner.
What to Expect During the Procedure
Before the Procedure
- You’ll have a consultation with us to review your medical history and imaging results (MRI, CT scans, etc.).
- You may be asked to fast for a few hours before the procedure.
- This procedure is typically performed under local anesthesia, however, we do offer sedation services for this procedure. However, sedation is often not covered by insurance and may have an out-of-pocket cost. Please contact us for details.
During the Procedure
- Using X-Ray fluoroscopy, a thin needle is guided into the epidural space.
- Contrast dye is used to ensure the needle is in the correct position.
- Once positioned appropriately, corticosteroid medication along with local anesthetic is injected into the epidural space.
- After completing the injection, the back is cleaned and covered with a bandage dressing.
After the Procedure
- After the completion of the injection, an observation period of five to fifteen minutes is typical to ensure there are no reactions or side effects to the administered medication before being discharged home.
- The procedure usually takes about 5 – 10 minutes.
- Patients undergoing the procedure with local anesthesia can drive themselves home.
- Patients undergoing the procedure with sedation are required to have a chaperone or family member to drive them home.
Benefits of Epidural Steroid Injections
ESIs offer many advantages for patients looking for relief from chronic pain:
Effective Pain Relief
The injection reduces inflammation and relieves nerve pressure, providing significant pain relief within a few days.
Personalized Treatment
Each ESI is customized to target the specific area causing your pain.
Helps with Physical Therapy
Pain relief from ESIs allows you to participate in physical therapy, which can strengthen muscles and support long-term recovery.
Effective for Various Conditions
ESIs are a versatile treatment for many spinal conditions, making them an excellent option for managing pain.
Improved Mobility and Function
By reducing pain, ESIs allow you to engage in daily activities and physical therapy more comfortably.
Quick Procedure, Quick Recovery
The procedure usually takes less than 15 minutes, and many patients return to their regular activities the following day.
Long-Lasting Results
Relief from ESIs can last for weeks or months, and the procedure can be repeated if necessary.
Minimally Invasive
Unlike surgery, ESIs only require a small needle to perform their function, which reduces risks and recovery time.
Reduced Need for Medications
ESIs can help decrease reliance on oral medications such as opioids, thus reducing potential side effects and risks.
Low Risk of Complications
ESIs are generally safe, with minimal risks compared to surgery or long-term medication use.
Risks and Side Effects
Although ESIs are safe for most patients, there are some risks, including:
- Temporary soreness at the injection site
- Headaches
- Allergic reactions to the medication (rare)
- Minor bleeding
- Infection (rare)
These risks will be discussed in detail during the consultation appointment.
Take the First Step Toward Pain Relief
If you are suffering from chronic pain and believe an Epidural Steroid Injection could help, contact Vertex Pain Physicians today. Our expert team is here to help you find relief and get back to a healthier, more comfortable life.
Frequently Asked Questions
What are the risks of epidural steroid injections?
Risks include infection, nerve damage, headaches, and, in rare cases, long-term effects like osteoporosis or hormonal changes.
How effective are ESIs for back pain?
ESIs are highly effective for treating back conditions like herniated discs, spinal stenosis, and sciatica by reducing inflammation and nerve pressure.
What type of steroid is used in cervical ESI?
Common steroids used include methylprednisolone, dexamethasone, and triamcinolone, depending on the desired duration and intensity of relief.
How painful is the procedure?
Most patients feel minor discomfort or pressure during the procedure. Local anesthesia helps minimize any pain.
How painful is the procedure?
Typically, most patients receive 3–4 injections per year to maximize their pain relief while minimizing the side effects of corticosteroids.
Medical Disclaimer: The information provided on this page is for educational purposes only and is not intended as a substitute for professional medical advice, diagnosis, or treatment. Always consult with a qualified healthcare provider for any medical concerns.
