Epidural Steroid Injection


Epidural steroid injection, or ESI, is a minimally invasive dose of anti-inflammatory steroid medication into the epidural space to relieve pain in the neck, arm, back, and leg due to an infection in the spinal nerves. This quick and simple procedure, which has been used since 1952, is usually performed by soaking the inflamed nerve root in steroids to relieve patients suffering from these ailments, namely:

Spinal stenosis, an irregular narrowing of the spinal canal that commonly attacks people who are more than 50 years old, and/or younger men and women who either hurt their spines, or who have congenitally narrow spinal canal;

Spondylolysis, is a specific injury between the upper and lower facets of a vertebra most often caused by rigid movements of the body, and whose usual patients are the teenagers;

Herniated disc, also known as bulging disc, ruptured disc, or slipped disc, a common spine problem characterized by a protuberance of an inter vertebral disc through a delicate area in the annulus;

Degenerative disc, another common cause of low back pain characterized by numbing due to a decline of the inter vertebral disc as a sign of aging, and;

Sciatica, an irritation of the sciatic nerve characterized by pain in the leg, which is oftentimes excruciating, making it extremely difficult for patients to stand up or sit down.

ESI, however, is not applicable to patients who are pregnant, diabetic, have bacterial infections, or those who have problems with bleeding because the process might cause their blood sugar level to soar, stimulate high blood pressure, stomach pain, arthritis of the hips, and other related ailments.

Epidural steroid injection is recognized in the medical field as a basic component of non-surgical management of radicular pain due to lumbar spine disorders. It should be clarified, however, that ESI is not a cure for any disease it is usually applied to. Rather, it is only used to ease the pain and control the symptoms for a pro-longed period so that the patient may be able move about freely, become active, and participate in physical therapy program. Be-cause of this nature, the injection is, therefore, temporary and may last up to two months only. The medications used here are usually anaesthetic and cortisone. The anaesthetic, which is usually in the form of novacaine, lidocain, or bupivicaine, may cause a momentary numbness just like what it does when doing a suture on laceration or doing dental work; while cortisone is a very effective treatment to reduce swelling and inflammation in the nerves and connective tissues.

The modern ESI procedure is performed with the aid of a fluoroscope, a sort of x-ray machine that allows the doctor to actually watch where the needle goes as it is inserted; and once the needle reaches the spot to be treated, a little amount of radio-graphic dye is then injected to confirm the right position and further ensure that the medication would go right into where treatment should be go.

ESI is a safe procedure, although just like any other medical course of action, it is not 100 percent free of complications. However, its complications are only minor ones and not life-threatening, such as: allergic reaction; wet tap, which occurs when the epidural needle goes a bit off the target site and a hole is created in the dura that may result to a spinal fluid leak; headache, and; nausea. Other complications, which very rarely occur, include epidural hematoma, epidural abscess, and nerve damage, which may then require surgery.

After the ESI procedure to help reduce the SI joint pain, the patient is normally allowed to go home, and may not necessarily be bound to perform any activity at all, or restricted on diet.