An epidural steroid injection (ESI) involves injecting the space around the spinal cord with an anti-inflammatory agent. The injection is done between two vertebrae, and involves no incision on the skin. Often done in a series of three spaced out over several months, ESIs offer many benefits to the patient.
No. 1: Offers Long-Term Pain Relief
Back pain is a serious problem. The spinal nerves that branch off the spinal cord become irritated from compression or leaking disc material. Injecting a steroidal agent onto the nerves will help alleviate pain. According to some clinical studies, ESI pain relief lasts for 2-6 months. The duration of pain relief varies, depending on the severity of the patient’s condition.
No. 2: Minimally Invasive
The ESI procedure is minimally invasive, and it does not require being put to sleep. The doctor only has to insert the procedure needle into the epidural space, inject the steroid (with or without an anesthetic agent), and then remove the needle. The procedure is fairly straightforward, and does not require extensive manipulation of the spine.
No. 3: Uses Fluoroscopy
To verify that the needle is placed in the right position, the doctor uses an x-ray machine (fluoroscope), which allows him to visualize the spinal components. This means there is no risk of puncturing nerves or blood vessels during the procedure.
No. 4: Reduces Extremity Weakness and Numbness
The corticosteroid often used for ESI is betamethasone (Cortisone). This powerful anti-inflammatory agent reduces swelling and inflammation of nerves and connective tissues. Reducing swelling allow the nerves to function better, which can reduce extremity weakness and numbness.
No. 5: Has Few Adverse Reactions
Because a steroid agent is used, you may experience a slight weight gain and increased appetite. Adverse reactions and events are rare, but include blood vessel and nerve damage, bleeding, and increased pain.
No. 6: Only has to Be done Once every 6 Months
Most doctors offer the injections every 6 months if shown effective. In addition, most pain management specialists limit the number of injections to 3-5 per year. This is so that you do not get too much cortisone in your body.
No. 7: It Works?
According to many clinical studies, epidural steroid injection works. A recent study assessed the effectiveness of ESI for lumbar radiculopathy when the nerve root compression was at the level of the supra-adjacent disc. Researchers found that it had a success rate of 90% for relieving pain. Another study evaluated ESI for cervical radiculopathy. The researchers discovered that patients with herniated disc had an 86% success rate regarding symptom relief.
No. 8: Does NOT make You Groggy
Unlike powerful pain medications that cause drowsiness, grogginess, and dizziness, the ESI procedure allows you to remain alert and continue to function normally. Most patients report that they have no side effects to the procedure.
No. 9: Is Tried and True
Because the ESI has been around as a procedure for decades, the technique is tried and true for pain relief. The pain management specialist has performed hundreds of these procedures, so the risk of technical problems is low.
No. 10: Treats Many Back Conditions
Several back conditions can cause nerve impingement and chronic pain. The ESI is used to treat cervical herniated disc, lumbar herniated disc, radiculopathy, spinal stenosis, and spondylolisthesis.
Kwon JW, Lee JW, Kim SH (2007). Cervical interlaminar epidural steroid injection for neck pain and cervical radiculopathy: effect and prognostic factors. Skeletal Radiol, 36(5), 431-436.
Lee JW, Kim SH, Choi JY, Yeom JS, Kim KJ, Chung SK, et al. (2006). Transforaminal epidural steroid injection for lumbosacral radiculopathy: preganglionic versus conventional approach. Korean J Radiol, 7:139–144.