All You Need to Know About Epidurals For Back Pain

10 Apr, 2024

Epidural Steroid Injections (ESI) are used to treat severe back pain. Strong anti-inflammatory medicine is injected directly into the epidural space, which refers to the space outside of the sac of fluid surrounding your spinal cord. ESIs are different from epidural anesthesia that is commonly used during childbirth or certain kinds of surgery. 

What To Expect When Getting An ESI

ESIs are performed by medical providers in a hospital or outpatient clinic in the following manner:

  • The patient changes into a gown and lies face down on an X-ray table. If they are unable to do so, it may be performed sitting up or in a fetal position.
  • The area of your back where the needle will be inserted is cleaned, and medicine may be applied to numb the area or to help you relax.
  • A needle is inserted into your back, which is typically guided to the correct spot by an X-ray machine producing real-time images.
  • A mixture of numbing medicine and steroid is injected into the area in order to lower swelling and subsequent pressure on the nerves around your spine to help relieve pain. This may also be used to help pinpoint the painful nerve.
  • Expect some pressure during the injection, though typically the procedure isn’t painful. 
  • You can go home after 15-20 minutes of supervision.

Who May Get An ESI?

Your doctor may recommend ESI to treat pain radiating from the lower spine down the leg or to the hips, as it is often caused by pressure on a nerve due to a bulging disk or other types of swelling. ESIs are only used after nonsurgical treatments such as medication, physical therapy, and rest are proven ineffective.

What Are The Risks Of An ESI?

ESIs are very safe procedures, but like any medical procedures there are potential complications such as:

  • Nerve root damage that cases increased pain down your leg
  • Headache, dizziness, or feeling intense nausea
  • Allergic reaction to the medication
  • Meningitis or abscess
  • Possible rare nervous system and brain issues
  • Hematomas
  • Difficulty breathing if the injection was done in your neck

Frequent injections may weaken the spinal vertebrae or surrounding muscles. Higher doses of the steroids in the injections may compound these issues. Due to this, most providers set a limit for injections at two or three injections per year. Before the procedure is performed, your provider will probably have already ordered imaging such as MRIs, X-rays, or CT scans of your back in order to pinpoint the area they are going to treat.

Recovery After The Procedure

Recovery time is typically very short for an ESI; after the injection, you may feel mild discomfort in the area where the needle was inserted, which should go away after a few hours. It is recommended to take it easy for the rest of the day. Your pain may worsen for 2-3 days after the injection before it starts fading, as the steroid typically takes 2-3 days to take effect.

Contact Us Today

ESIs are a relatively safe and painless procedure that requires minimal downtime. Consult with your doctor if you are considering this procedure. Call The Spine and Scoliosis Center to schedule an appointment with a top spine specialist today.


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