Category: Injections | Author: Stefano Sinicropi
Today’s blog marks our fifth installment of the “Injections 101” series. We’ve already covered Radiofrequency Ablation, Stellate Ganglion Blocks, Sacroiliac Joint Injections, and Lumbar Sympathetic Blocks. Today we turn our attention to Epidural Steroid Injections.
What Is An Epidural Steroid Injection?
An epidural steroid injection, or ESI for short, is a minimally invasive injection that aims to provide relief for pain caused by an inflamed spinal nerve. Your spine is home to countless nerves that branch all throughout your body, so depending on where the inflamed spinal nerve is located, it may be causing pain in your arm, back, leg or neck. Additionally, epidural steroid injections can provide pain relief from certain spine conditions, like spinal stenosis, spondylosis or disc herniation.
The injection itself includes a corticosteroid and an anesthetic numbing agent. The drugs are carefully injected into the epidural space in the spine, located between the protective spinal cord covering (the dura) and the bony vertebrae.
How Is An Epidural Steroid Injection Performed?
The procedure is typically performed on an outpatient basis, so while you should be able to leave the clinic shortly after the injection, it is recommended that you bring a friend or family member to drive you home after the injection as numbness could affect your driving ability. Here’s how the injection is performed:
- The patient is placed face down on an X-ray table. Local anesthetics are placed on the injection site to numb the area. You will be awake during the procedure, and the majority of patients report minimal discomfort.
- With the aid of a fluoroscope (x-ray guidance) the surgeon will place the injection needle under the skin until it reaches the epidural space.
- Depending on the location of the pain, your surgeon will either perform a Transforaminal ESI or an Interlaminar ESI. In a transforaminal ESI, the injection is placed to the side of the vertebra in the neural foramen, while an interlaminar ESI involves injecting the solution between the lamina of two vertebrae. Your doctor will determine which injection site is best prior to the procedure.
- The medication is injected, and the needle is slowly removed. The injection site is then addressed with a small bandage. The procedure generally takes 15-40 minutes.
Risks And Follow Up
A person can usually walk around immediately after the injection. You may be monitored for 5-10 minutes, but you will eventually be given clearance to leave the surgical center, assuming you have a ride. You should be able to return to work the next day unless your surgeon advises otherwise.
You’ll likely notice that pain has decreased in the days and weeks after the injection, but there’s no guarantee that the injection will provide long-term relief. Some physicians recommend that you start a pain journal to track your pain in the weeks after the injection. Some patients will return for subsequent injections after the effect wears off, while some experience years of relief, so talk with your surgeon about any future injections if pain starts up again. You’ll also be given some strengthening and physical therapy routines based on your spine condition to strengthen the area and hopefully keep pain at bay.
Risks and complications from an ESI are rare, but here’s a list of some of the potential risks:
- Nerve damage
- Allergic reaction to medication
- Spinal headache from dural puncture
Minnesota Spine Surgeon
Surgeons account for these risks to ensure you have the safest procedure possible. So if you’re suffering from arm or leg pain due to a spinal nerve issue, contact Dr. Sinicropi today to see if you are a candidate for an epidural steroid injection.