Upstate Carolina Radiology

Epidural Steroid Injections

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Epidural Steroid Injections (ESIs) are used to relieve inflammation and pain from back and/or leg pain, sciatica. In addition, Epidural steroid injections may be used in the neck or cervical area to relieve pain. Epidural steroid injections have been used since 1952 for pain relief and most often in conjunction with a rehabilitation plan to help the healing process of the injured area.

Epidural steroid injections deliver an anti-inflammatory agent, or cortisone, and a fast-acting local anesthetic for temporary relief of pain. Inflammation is a common result of back injury and reducing the inflammation will give the affected area temporary relief of the pain. For instance, if a herniated disk is present, the disk may press on a nerve, which can cause swelling and irritation and in turn result in leg pain, sciatica. Reducing the inflammation will decrease the nerve inflammation and give the body the ability to do rehabilitation exercises and stretching.

Common Uses for Epidural Steroid Injections

  • Lumbar degenerative disk disease, where degeneration of the disks may cause collapse of the disk space where bony spurs may press on nerves
  • Lumbar disk herniation or annular tear, where the nucleus of a disk becomes displaced and creates pressure on the spinal cord and nerves
  • Lumbar spinal stenosis is a narrowing of the spinal canal that causes terrible pain
  • Compression fracture, where the vertebral body may press on nerves
  • Synovial cyst in the lumbar spine
  • Degenerative arthritis of the spine

How Are Epidural Steroid Injections Performed?

Our Interventional Radiologists perform this procedure with fluoroscopy, real-time x-ray, guidance. The patient will be placed on an x-ray table either flat or with a pillow to make the area of concern more easily accessible. The target area will be cleaned and slightly numbed with a local anesthetic. Using the fluoroscopy guidance, the needle will be inserted directly into the epidural space. Contrast will then be injected to be sure that the needle location is accurate for the patient’s pain and inflammation. Once accurate location is determined, the epidural steroid injection, and sometimes anesthetic, is injected into the epidural space. This procedure normally takes about 10-15 minutes followed by a small recovery period.

What Takes Place After the Procedure?

Patients may be monitored for a short time to ensure that the procedure was received well. The patient may have slight discomfort from the fluid pressure, but should have maximum benefit from the medicine within approximately seven days. A driver should accompany the patient to the facility to take them home safely.
Some injections are ordered in sets of two or three, depending on what the epidural steroid injection is treating. Traditionally, a patient should not have more than three ESIs in a year.

Please consult your physician if you experience any side effect, such as painful headache; fever of over 101; loss of function or feeling in arms or legs; loss of bowel or bladder control; and severe pain not controlled by over-the-counter pain medications.

For any further questions, please consult your physician.

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