Epidural Steriod Injections

Overview: Epidural steroid injection is a term applying to a variety of techniques performed to deliver a corticosteroid preparation into the epidural space of the spine. Three routes may be used in the spine:
1. caudal
2. interlaminar
3. transforaminal

Why choose epidural steroid injections?

The primary indication for an epidural steroid injection is to try and relieve pain due to inflammation of the nerve elements in the epidural space of the spine. Corticosteroids are known to have strong anti-inflammatory properties. Locally, corticosteroids are thought to act to inhibit the inflammatory response induced by mechanical, chemical, or immunologic agents. The reason to perform the epidural is lack of response to conservative care or a diagnostic need to determine the spinal source for the symptoms.

Risks: Complications can occur from these injections including: infections, discitis, nerve damage, paralysis, extremity weakness, bleeding hematomas, and dural punctures leading to headaches. Intravenous injection is also possible, but can be minimized using fluoroscopy contrast. Lastly, the injection procedure may not improve your pain or unfortunately, may worsen your pain.

Treatment: All procedures are done with fluoroscopic x-ray guidance to ensure safety. During the procedure, medication is placed as close to the pathologic process as possible in order to gain the best possible therapeutic benefit. The treatment is used to achieve a significant reduction in pain and improve function without the need for surgery. More than a single injection may be required in any given patient. The effects may last from a few weeks to a few months, but cannot be predicted.