Epidural Steroid Injection or ESI

An epidural steroid injection places a powerful anti-inflammatory medication directly around the spinal nerves. To administer the epidural steroid injection, your doctor will have you lie flat, face down, on an x-ray table. Using the x-ray to visualize the location of the tip of the needle, your doctor will guide the needle to an area very near to the spinal nerves, called the epidural space. Using the x-ray improves the chance the medication will be given in the proper location. The epidural steroid injection lasts about 15 minutes, and light sedation may be used if needed.

Epidural steroid injections may be given by many types of physicians, including anesthesiologists, orthopedic surgeons, neurologists, interventional radiologists, and others trained in this technique. Usually a series of injections, often three, each spaced apart by several weeks, are given. With this schedule, many patients find relief of symptoms within a few weeks. Often this helps control the inflammatory process and may provide long-lasting relief.

Side-effects from epidural steroid injections are rare, but should be discussed by the provider prior to performing the injection. These include:

• Infection: Very unusual (less than 0.5%), and usually avoided by using a sterile technique.
• Bleeding: Also unusual, and avoided by not performing this procedure on patients with bleeding disorders or those on blood thinning medication.
• Dural Tears: Caused by piercing the sac around the spinal nerves with the needle. This usually results in a headache.
• Increased Blood Sugar: Diabetics must carefully monitor their blood sugar after this or any other steroid injection.
  Aseptic meningitis.

Other side-effects are possible, and should be discussed prior to injection with the doctor performing this procedure.