If you are suffering from severe and chronic pain in the upper or lower back, neck, or legs, and it’s affecting your ability to function normally, you may want to consider an epidural steroid injection or ESI for short. Read on to find out what it is, how it works, and if this may be a solution for you.
What Is an ESI?
An epidural steroid injection is an outpatient procedure that delivers relief from pain that originates around the spinal column. Medication such as a steroid or other anti-inflammatory is injected into what is called the “epidural space,” or space around the spinal cord. This injection reduces inflammation, giving immediate pain relief, and allowing the affected areas to heal over time.
There are different types of ESIs that vary according to the injection site and the targeted area. Two of the most common are cervical epidurals, which treat pain and swelling in the neck or upper back region, and lumbar epidurals, which target pain in the lower back area or legs.
Reasons for Getting a Cervical or Lumbar Epidural
An epidural steroid injection may be right for you if you have:
- Chronic back or leg pain after spinal surgery
- Pain due to injuries to spinal nerves, vertebrae, and surrounding tissues
- Pain due to bone spurs
- Pain due to a herniated disc
- Pain due to spinal stenosis (narrowing of the spinal canal)
What Are the Risks of an ESI?
Before deciding with your doctor if an epidural steroid injection is the right course of action for you, there are some risks involved with the procedure that you should be aware of. While most of these are very rare, there is a very small chance the following complications could happen:
- Bleeding is rare and typically happens only if there is an underlying bleeding disorder.
- Nerve Damage is very rare, especially due to the fact that the procedure is done with x-ray guidance.
- Infection could happen on rare occasions, but it’s very unlikely.
- Dural Puncture Headache, while very rare, is a possible complication of a spinal puncture.
How Is an Epidural Steroid Injection Done?
Depending on where you are experiencing pain, the injection site of an ESI will vary. For a cervical epidural, the injection site will be around the neck, and for a lumbar epidural, it will be around the lower back.
The procedure begins with a local anesthetic injected into the skin and underlying tissue of the epidural site. The small, quick discomfort that is felt from the needle prick of the anesthetic will make the rest of the procedure pain-free and comfortable.
With x-ray guidance, a larger needle is then inserted into the numbed area. The steroid or anti-inflammatory medication is then injected into the epidural space that is affected.
What Can Be Expected After Getting an ESI?
The biggest expectation of an epidural steroid injection is pain relief. Some patients may experience some immediate relief, while for many others it may take a few days, or even up to a week. As with any procedure or medication, there may be some temporary side effects such as an increase in pain, changes to the menstrual cycle, anxiety, sleeplessness, fever, and facial flushing. However, usually, ESIs are tolerated very well, and the benefits far outweigh any side effects that may occur.
The pain relief from an epidural steroid injection may last up to several months and sometimes even longer. Often times, ESIs are done periodically, until the issue has been resolved. Along with the injection, your doctor may recommend some sort of physical therapy as well.