Epidural Steroid Injection (ESI)

ESIs may be indicated for relief of cervical, thoracic or lumbar pain not resolved with conservative medical management such as NSAIDS, physical therapy, chiropractic care or acupuncture. This injection is delivered into the epidural space of the spine. The epidural space is located outside the dura membrane. This injection provides temporary relief from pain, inflammation or both.  You will be placed on your abdomen on the fluoroscopy table.  The Interventional Radiologist will clean the area and use a numbing medication to anesthetize the site under x-ray guidance.  A steroid medication and a numbing agent is injected into the cervical, lumbar, thoracic or caudal space to relieve pain and inflammation. The injections are usually done in a series of 3.

If you are taking any "blood thinners" such as aspirin, Coumadin or Lovenox, they may need to be stopped prior to an ESI. Our staff will provide you with pre-procedure instructions. You may experience pain relief in 2-3 days. The procedure is minimally invasive and it only takes a few minutes to perform the procedure.  The risks include infection at the site of the injection, infection into the spinal canal or hematoma formation.

The pain relief produced by an epidural injection may be temporary or permanent (providing relief from pain for 1 week up to 1year), and about half of all patients get at least some relief. An injection can also provide sufficient pain relief to allow a patient to progress with a rehabilitative physical therapy program. If the initial injection is effective, the patient may have up to 3 in a 1 year period. In general, good candidates for epidural injections are patients with severe back or leg pain caused by:

  • Lumbar disc herniation
  • Degenerative disc disease
  • Lumbar spinal stenosis