Treatments

Overview

What is an Epidural Steroid (ESI) Injection?

An epidural steroid injection (ESI) is a common interventional pain management treatment used to deliver steroids directly into the epidural space in the spine. ESIs are specific to the epidural space around the spinal cord and are used to treat pain related to spinal nerves. These injections are typically guided by imaging techniques such as fluoroscopy to ensure accuracy and efficacy in delivering the medication to the intended area.

Where on the Body can It Be Used?

ESIs are commonly used for conditions that cause inflammation and pain around spinal nerves including:

• Cervical Spine (Neck Area): These injections target the cervical section of the spine (C1-C7) and are used to treat neck pain, radiculopathy, and other discomforts that may radiate into the arms.
• Thoracic Spine (Mid-Back Area): Although less common, thoracic ESIs are administered into the middle segment of the spine (T1-T12). They are used to address pain and symptoms associated with thoracic herniated discs, spinal stenosis, and other mid-back issues.
• Lumbar Spine (Lower Back Area): These are the most frequently performed ESIs, targeting the lower spine (L1-L5). They are effective for managing lower back pain, sciatica, and radiculopathy that affects the lower extremities.
• Caudal Epidural Space: This is the lowest part of the epidural space, accessed through the sacral hiatus a gap in the sacrum at the base of the spine. Caudal injections are particularly useful for treating lower back pain and radicular pain affecting both legs.

How does ESIs Work with other Treatments?

Epidural steroid injections are often part of a multimodal treatment approach, which can include:

• Physical Therapy: Following an ESI, physical therapy can be more effective due to reduced pain and inflammation.
• Medication Management: ESIs may reduce the need for oral pain medications or allow for lower doses.
• Behavioral Therapy: Reduced pain can make behavioral and psychological therapies more effective.
• Lifestyle Modifications: Including diet and exercise changes to improve overall health.
• Regenerative Medicine: To help accelerate the body’s healing ability using a person’s own platelets.
• Neuromodulation: If chronic pain persists, advanced pain management techniques like neuromodulation maybe required.
• Behavioral Therapy: To help manage the psychological impact of chronic pain.