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ESI (Epidural Steroid Injections)

Epidural Steroid Injections have been used for many decades now to treat low back-related leg pain, or neck-related arm pain, both of which are results of inflamed spinal nerves.

Commonly Asked Questions About ESI:

ESIs are the injection of steroids in the spinal area to relieve pressure on spinal nerves that have become inflamed in their narrowing passages of travel. ESIs are a commonly used treatment for low back/leg pain or neck/arm pain. 

There are two types of administration, both done by needle: an interlaminar ESI spreads the steroid over a wider area while a transforaminal ESI, or “nerve block,” injects the steroid alongside the nerve in the epidural (cushion) space around the spinal cord. 

ESIs relieve pain from herniated discs, pinched nerves, bone spurs, thickening of the ligaments in the spine, joint cysts, slipped vertebrae, and other back pain generators. 

Unless they request it, patients aren’t sedated for this procedure because it’s generally well-tolerated and not too painful. We will sometimes offer patients a valium or mild sedative to take before the procedure if they are feeling anxious. Before the pain being treated subsides, it may temporarily increase for a few days, but this is unusual. 

Pain may temporarily increase for a few days following the procedure. Although uncommon, some patients experience flushing of the face and chest followed by feelings of warmth or possible rise in temperature, but these symptoms disappear after several days. Extremely rare are allergic reactions, bleeding, infection, nerve damage, or paralysis. 

The test is often followed up with physical therapy with an emphasis on a home exercise program. If the injection provides significant relief, it’s possible the patient may receive multiple injections per year.