Epidural Steroid Injections (ESIs)
Epidural steroid injections have been found to be an effective adjunct to treatment for patients with neck, lower back, arm and leg pain. Commonly, nerves in the neck or back are compressed near the spine by a bulging disc, bone spur, or scar tissue. This causes the nerves to become irritated and swollen, causing pain, numbness or tingling radiating into the arms or legs. The purpose of the epidural injection is to decrease inflammation and provide pain relief, thereby facilitating more active therapy. Their primary use is part of one component of a comprehensive treatment plan that includes medication, physical therapy, and education in body mechanics.
The patient is typically placed face down for the procedure, and the area to be treated cleansed with an antiseptic solution. Under live fluoroscopy, the needle is guided into the epidural space and the steroid solution is injected. The area is numbed with local anesthetic prior to the injection, so there is minimal discomfort. The procedure takes normally no more than 2 minutes to perform in the office.
The medication starts to work immediately but takes about 48 hours to become fully effective. You may feel relief before leaving the office that day. Patients are typically returned to the office within 2 weeks for a recheck and it can be repeated up to a total of three times in a calendar year safely.