Epidural Steroid Injection

An epidural injection is a steroid injection inserted into a specific location in the spinal canal of your low back by a specialist under fluoroscopy (x-ray guidance). The injection bathes the irritated nerve root in a combination of steroid and anesthetic. The steroid reduces the inflammation and irritation and the anesthetic works to interrupt the pain-spasm cycle and pain signal transmission. The combination medicine then spreads to other levels and portions of your spine, reducing inflammation and irritation. The entire procedure usually takes less than fifteen minutes.

Types of Epidural Injection:

  • Intralaminar Injection – After your skin is anesthetized the needle enters the mid-line of your back, between the most prominent bones in the mid-line of your spine. The needle enters through the space between two vertebrae. The combination of steroid and anesthetic is then delivered into the epidural space (the fluid-filled space between the spinal cord and vertebrae) in the mid-line and spreads to the nerve roots on both sides of your spine.
  • Transforaminal Injection – After your skin is anesthetized the needle enters through the side of your vertebrae above the opening for the exiting nerve root. This approach treats one side at a time and is thought to be more specific. Physicians treating patients who have undergone previous spine surgery and have foreign bodies (surgical pins, surgical rods, screws) as well as previous scarring, prefer this method because they are able to avoid these structures.
  • Caudal Injection – After your skin is anesthetized a needle enters the epidural space by your tailbone. This technique allows for a catheter to be placed and larger volumes of steroid and anesthetic to be delivered. The additional medication can be used to affect more nerve roots distributing to the inflamed area at the same time.

Who is a candidate for an Epidural Injections?

  • People who suffer from acute neck pain
  • People who suffer from acute back pain
  • People who suffer from radiating leg pain

Benefits of an Epidural Injection:

  • Non-surgical
  • Relatively painless
  • Decreased swelling and pain
  • Immediate pain relief
  • Improved mobility
  • Minimal side effects

Risks of an Epidural Injection:

  • Medication side effects
  • Allergic reaction to steroid
  • Shrinkage and lightening of the color of the skin at injection site
  • Infection
  • Local bleeding
  • Soreness at injection site
  • Post-injection flare-aggravation of inflammation in the area injected

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