Epidural Steroid Injection

An epidural steroid injection is a minimally invasive procedure that involves delivering a long-acting corticosteroid and anesthetic into the epidural space. The anesthetic provides immediate pain relief whereas the corticosteroid reduces inflammation. The injection can be administered into the epidural space at the cervical (neck), thoracic (middle back), or lumbar (lower back) levels. The epidural space is located between the dura (membrane covering the spinal cord and nerve roots) and the bony vertebrae.

Epidural steroid injections may be used for both diagnostic and therapeutic purposes. If the procedure is used for diagnostic purposes, medication is delivered at a particular spinal nerve root. If the response is favorable, it can help prove the pain is indeed originating from inflammation at that specific location. This helps in guiding future treatment options including any future surgical interventions.

When the procedure is used for therapeutic purposes, the goal is to temporarily reduce neck, arm, leg, and back pain caused by inflamed nerves. Conditions that often contribute to nerve inflammation include herniated discs, spinal stenosis, degenerative disc disease, spondylolysis, etc. The procedure will not correct these preexisting conditions, but may reduce the pain associated with them and allow for rehabilitation.

The therapeutic effect from an epidural steroid injection can last anywhere from weeks to years. If only mild pain relief is achieved after the first injection, one to two more injections may be performed, usually in 2-week intervals. It is important to coordinate the injections with the start of a rehabilitation program to avoid further pain episodes and improve outcomes.

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Information from the National Institutes of Health, April 2010