What is an epidural steroid injection?
An epidural steroid injection (ESI) involves immersing nerve roots in steroids to relieve pain, usually in the lumbar area. It is an outpatient procedure that can be performed in the office with local anesthetic, or in a facility with conscious sedation (a safer alternative to general anesthesia).
As opposed to oral steroids or painkillers, Epidural steroids have a more focused area of delivery, and are delivered closer to the pain source, thus creating more impactful pain relief.
What it an ESI used to treat?
An ESI treats:
- Lumbar spinal stenosis
- disk herniation
- bone spurs
- annular tears
- degenerative disc
- and other neck, leg and back pain.
The pain is usually caused by spinal nerve irritation from tissue pressing against the nerve roots.
What does the shot look like?
A steroid (typically cortisone) and local anesthetic (lidocaine or bupivacaine) solution, and/or saline is used.
Where is an epidural steroid shot injected?
The ESI shot is administered in the epidural space (the space around the spinal cord).
Is an ESI painful?
The day of and the following day you may feel some discomfort in the injection areas. The shot itself, however, takes only a few minutes to administer in a relatively painless procedure.
What can I expect during an epidural steroid injection procedure?
In The Office
Step 1: Meet With Your Doctor
In the office, you will meet with your doctor in the exam room first. They will go over all the risks and benefits of this procedure.
Step 2: Needle Insertion
Then, you will be taken to the exam room and prepped for the injection. You will be asked to lay face down on the exam room bed and a fluoroscopy guidance machine will be brought into position.
Step 3: Steroid Injection Procedure
Your doctor will then numb the area with a local anesthetic and then insert an epidural needle into the epidural space. A small amount of dye will be injected to show the correct placement has been achieved. The doctor will inject the steroid through the epidural needle and the needle is removed. The medical assistant will clean up the skin and place a bandage over the injection site. You will be monitored for about 5 minutes after the procedure.
In A Facility
Step 1: Prep & IV-Conscious Sedation
In a facility, you will check into the facility an hour and a half in advance. You will be asked to fast for 6 hours prior to your procedure. You will be brought back and prepped by a nurse on staff. They will insert the IV for the conscious sedation.
Step 2: Needle Insertion with Fluoroscopy
Once in the procedure room you will be placed in the prone position and a fluoroscopy guidance machine will be brought into position.
Step 3: Steroid Injection
Your doctor will numb the area with a local anesthetic and then insert an epidural needle into the epidural space. A small amount of dye will then be injected to show the correct placement has been achieved. The doctor will inject the steroid through the epidural needle and the needle is removed. The medical assistant will clean up the skin and place a bandage over the injection site. You will be monitored for about 30 minutes after the procedure.
Is there anything I need to tell my doctor prior to this procedure?
You should tell your doctor if you are pregnant, on blood thinners, diabetic, or if you have any other concerns you would like to address beforehand.
What happens after the injection?
You will be asked not to drive for at least 24 hours after the procedure and you must have a driver to drive you home from our office.
How long does it take for the injection to take effect?
It takes 3-5 days for the steroid to fully kick in. Additional injections may be needed for optimum relief. Sometimes, these injections are done in a series of 2 or 3, and generally up to 3 per year.
How long will nerve, back, and disc pain relief last?
The duration of the pain relief will vary from patient to patient. It can last from only a few days to a matter of months. Some may even experience permanent relief after their epidural injection.
Many times, an injection is paired with another method of pain relief to provide additional relief.
Are there any side effects from Epidural Steroid injections?
Though risks are few: potential epidural steroid procedure risks include:
- allergic reaction
- nerve damage (rare)
- weight gain
- water retention
- hot flashes / flushing
- elevated blood sugar in diabetes patients.
The above information is for general education purposes only. Please ask your doctor specific questions during your visit.
Our specialists at Oklahoma Pain Management will make sure you get the treatment you need to find relief, so you can focus on what’s important.