Epidural Steroid Injection (ESI)
Epidural Steroid Injection (ESI): Epidural steroid injection is a fluoroscopically guided procedure that involves injecting a medication that contains corticosteroid and anesthetic into the epidural space to relieve back pain.
The epidural space is the area between the bony vertebra and the protective sac of your spinal nerves. The epidural space is filled with cerebrospinal fluid and it provides cushioning for your spinal nerves and spinal cord.
Epidural steroid injection can be given to patients during and after surgery to relieve pain. It relieves back and leg pain and inflammation in and around the spinal nerve roots. Epidural steroid injection provides pain relief that can last for weeks to months.
Caudal Epidural Injection
Caudal epidural injection is the epidural injection given into your lower back or tail bone. The medication containing anesthetic and steroids goes into the lower part of your epidural space. You may need caudal epidural injection if you have lower back pain or leg pain.
Effect of supraneural transforaminal epidural steroid injection
Transforaminal injection can help relieve pain in your lower back, legs and feet which could be caused by sciatica, herniated discs or any other back problems.
Nerves run from your spinal cord out to your legs. When any of these nerve roots get irritated and inflamed, it causes pain that can radiate from your back to your legs and feet.
An epidural steroid injection can help reduce inflammation and alleviate the pain. Some patients have reported pain relief within 30 minutes after having the injection. When the effect of the anesthetic wears off, pain may return a few hours later. It may take 2-3 days for the steroid to take effect. When the steroid starts to work, it provides longer-lasting pain relief. Pain relief can last for several months or longer.
Epidural injections for back pain
Epidural steroid injections are a common treatment for many forms of back and leg pain. Epidural steroid injections have been used for decades and are considered effect treatment for back pain
It is known as epidural steroid injection because it involves injecting a medication containing local anesthetic and steroid directly into the epidural space that surrounds the spinal cord and nerve roots.
Epidural steroid injection relieves pain by reducing inflammation in and around the nerve roots. It helps to improve mobility and function in the back and legs.
Epidural steroid injection procedure
First, you will be asked to lie down on your stomach on an x-ray table. You will be given a local anesthetic at the injection site to numb the area so that you don’t feel pain and to make you feel comfortable. You will be awake to provide feedback to your doctor.
With the aid of fluoroscopy guidance, your doctor will direct a hollow needle through your skin and between the vertebrae into the epidural space. Your doctor views the direction of the needle on a screen.
When the needle is in the right position, a contrast dye is then injected into the area to allow your doctor to see clearly the target nerves responsible for the pain. When your doctor has confirmed that the needle is in the right position, the medication will then be injected into the epidural space to numb the nerves. The needle will be removed and the injection site will be covered with a small bandage.
Epidural steroid injection success rates
Epidural steroid injections have been used for decades and are considered one of the safest and effective pain management treatments for lower back pain. An analysis of several clinical trials shows that 40% to 80% of patients experienced over 50% improvement after having epidural steroid injection.
Side effects of epidural steroid injections
Potential side effects include:
- Bleeding
- Infection
- Allergic reaction
- Spinal headache
- Water retention
- Weight gain
- Elevated sugar level
- Mood swings
- Insomnia
- Flushing
- Rare cases of nerve damage or paralysis
FAQS
What to expect after lumbar epidural steroid injection ?
Lumbar epidural steroid injection is an outpatient procedure. This means you can go back home the same day after the injection.
After the injection, you will need to avoid strenuous activity for a few days. You will also need to avoid driving for the first 24 hours.
You may notice some soreness near the injection site which will resolve in a few hours or days.
You can resume normal activities after 24 hours. You will experience immediate pain relief as the anesthetic starts to work almost immediately. The effect of the anesthetic lasts for just few hours. You will begin to feel pain again when the effect of the anesthetic wears out. It usually takes 2-3 days for the steroid to take effect. The steroid provides longer-lasting pain relief.
What are the side effects of steroid injections for back pain?
Possible side effects include:
- Nausea
- Dizziness
- Headache
- Pain and discomfort for a few days
- Infection
- Redness and a feeling of warmth on the face for a few hours
- Fainting due to anxiety from the procedure
- Pale skin around the injection site
- Increase in blood sugar levels for people with diabetes
- Increase in blood pressure for people with high blood pressure
How long do epidural injections last for back pain?
Epidural injections can last for a 3-6 months.
What is the success rate of epidural steroid injections?
Epidural steroid injection has shown good results in pain management. Over 80% of patients have experienced over 50% improvement in their pain after having epidural steroid injections.
How long does it take for an epidural steroid injection to work?
Most patients usually experience immediate pain relief as the anesthetic starts to work almost immediately. It takes 15-30 minutes for the anesthetic to take effect. The effect of the anesthetic lasts for just a few hours. You will begin to feel pain again when the effect of the anesthetic wears out. It usually takes from 2-3 days to 7-10 days for the steroid to take effect. The steroid provides longer-lasting pain relief.
What is the difference between a cortisone shot and an epidural steroid injection?
Steroid is a short form for corticosteroid. Epidural steroid injection is a procedure that involves injecting steroids into the epidural space. Cortisone is a type of steroid.
Do epidural injections help bulging disc?
Epidural steroid injections are used to treat back pain caused by a herniated or bulging disc.
What should you not do after an epidural steroid injection?
- Do not drive for 24 hours
- Do not drink alcohol for 24 hours
- Avoid strenuous activities for 72 hours
- Avoid applying heat to the injection site for 72 hours
- Avoid saunas or steam rooms for 72 hours
