Epidural Steroid Injections | Pain and Spine Specialists

Epidural steroid injections (ESIs) deliver anti-inflammatory medications directly to the epidural region of the spine. The nerves within the region are bathed in the steroid and anesthetic, inhibiting the pain from being able to radiate. By reducing the inflammation and pressure on spinal nerves, ESIs are highly effective in reducing pain associated with various back pain conditions.

It is important to note that ESIs are not injected into the spine, just the surrounding epidural region. The nerves in the epidural region travel to the mid back and along the body’s ribs. Any type of inflammation in this region, whether caused by damaged discs or damage to the bony structure of the spine, can be treated with an epidural pain injection.

ESIs are particularly effective because they deliver steroid medication directly to the source of the pain. Unlike oral medications, which must be absorbed by the body, ESIs provide more targeted relief. Our physicians may also use additional fluids with the steroid, such as an anesthetic and a saline solution, to help flush out any additional sources of pain in the epidural region. This method of delivery reduces the potential side effects that can occur when medications are administered orally, such as stomach irritation.

The three main types of epidural steroid injections are caudal, interlaminar, and transforaminal.

-Caudal Epidural Steroid Injections: A caudal ESI is the simplest form of steroid injection in the back. It is administered into the lowest portion of the epidural space. This method is best for treating widespread or diffused pain. It is done through the bony opening of your tailbone and is considered the safest method.
-Interlaminar Epidural Steroid Injections: An interlaminar injection delivers the anesthetic and steroid medication between the laminar of two adjacent vertebrae. The physician administering the injection takes a central approach to the bones of the adjoining spinal segments. This method commonly treats back pain due to herniated discs and spinal stenosis, and it is optimal for relieving radicular pain.
-Transforaminal Epidural Steroid Injections: The transforaminal epidural steroid injection (TFESI) is also injected into the epidural space, but the medical professional delivering the injection takes a lateral approach to the spine. The TFESI is injected where the nerves from the spine move toward the rest of the body. This injection also offers diagnostic ability because it can be directed at specific nerve roots.

ESIs are used to treat a range of back pain conditions, including:

-Herniated Discs: Herniated discs occur when the soft, jelly-like center of a spinal disc ruptures or bulges out. The herniated disc can irritate nearby nerves and cause pain, numbness, or weakness in an arm or leg.
-Spinal Stenosis: Spinal stenosis occurs when the open spaces within your spine become narrowed, causing pressure on the spinal cord and nerves. Spinal stenosis often results in pain, numbness, or weakness in the arms or legs.
-Sciatica: Sciatica describes pain that radiates along the path of the sciatic nerve, which branches from your lower back through your hips and buttocks and down each leg. The most common cause of sciatica is a herniated disc.
-Degenerative Disc Disease (DDD): DDD refers to the gradual wear and tear of spinal discs that occur over time. As we age, our spinal discs dry out, become stiffer, and lose height, causing pain and discomfort.

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