Epidural Steroid Injections (ESI) for Pain Management
Epidural Steroid Injections
Treatment Overview
Epidural steroid injections (ESIs) are a proven safe and effective non-surgical treatment for pain caused by inflammation. An ESI will not cure or correct the preexisting medical condition
causing the pain, but it may reduce the level of pain for months to years.
Epidural Techniques & Types
Epidural steroid injections (ESIs) are a versatile and effective treatment option for relieving pain in various parts of the body, including the neck, shoulders, back, arms and legs. Two common techniques for administering ESIs are Interlaminar and Transforaminal, each targeting specific areas and types of pain.
- Interlaminar Approach: This technique delivers medication into the epidural space between the vertebrae, ideal for widespread lower back or neck pain. The pain specialist inserts the needle from the midline of the spine through the “interlaminar window.”
- Transforaminal Approach: This technique is often used to target irritated spinal nerve roots more precisely. It is more complex, requiring fluoroscopic guidance and may involve injections at multiple levels in a single procedure.
Both methods reduce inflammation and relieve pain; your healthcare provider will determine the best approach for your pain. Let’s take a look at the different areas of the body an ESI can treat:
Cervical Epidural Steroid Injection
Cervical Epidural Steroid Injection (Interlaminar): This injection targets the cervical (neck) region by delivering medication into the epidural space through the midline of the spine. It is used to relieve pain and inflammation from conditions such as herniated discs, cervical radiculopathy or spinal stenosis affecting the neck, shoulders and upper arms.
Cervical Epidural Steroid Injection (Transforaminal): Administered in the cervical region, this injection focuses on delivering medication near the nerve roots as they exit the spinal column. It targets pain radiating into the arms or hands caused by nerve root irritation, herniated discs or cervical radiculopathy.
Lumbar Epidural Steroid Injection
Lumbar Epidural Steroid Injection (Interlaminar): This injection focuses on the lumbar (lower back) region, with medication placed into the epidural space through the midline. It is used to address widespread lower back pain and inflammation caused by conditions such as herniated discs, spinal stenosis or degenerative disc disease.
Lumbar Epidural Steroid Injection (Transforaminal): Administered in the lumbar region, this injection targets medication near the nerve roots as they exit the spinal column. It is beneficial for relieving localized pain radiating down the legs, such as sciatica, caused by nerve root compression or herniated discs.
Thoracic Epidural Steroid Injection
Thoracic Epidural Steroid Injection (Interlaminar): This injection is performed in the thoracic (mid-back) region, with medication delivered into the epidural space from the midline. It helps manage pain and inflammation due to conditions such as thoracic radiculopathy, spinal stenosis or post-surgical discomfort affecting the mid-back area.
Thoracic Epidural Steroid Injection (Transforaminal): Targeting the thoracic region, this injection delivers medication directly to the nerve roots as they exit the spinal column. It is effective for relieving pain that radiates along the rib cage or middle back, often due to nerve root irritation or thoracic disc issues.
Caudal Epidural Steroid Injection
Caudal Epidural Steroid Injection: This injection is performed at the sacral base of the spine, delivering medication into the epidural space through the sacral hiatus. It is used to relieve lower back pain and sciatica, particularly when other lumbar injections have been less effective or for pain originating from the sacrum or coccyx.
Who Benefits from Epidural Steroid Injections
Epidural steroid injections can effectively manage various pain conditions, including:
- Cancer Pain: Targeted relief for pain related to tumors or cancer treatments.
- Degenerative Disc Disease: Pain management for wear and tear on the spinal discs.
- Herniated Disc: Alleviation of pain caused by a herniated disc pressing on spinal nerves.
- Post-Surgical Pain: Alleviation of discomfort following surgical procedures, especially involving the spine.
- Sciatica (Lumbar Radiculopathy): Relief for pain radiating down the leg due to sciatic nerve irritation.
- Spinal Stenosis: Reduction of discomfort associated with spinal canal narrowing.
What to Expect
- Preparation: The procedure takes place at our same-day surgery center and does not require an overnight stay. You’ll change into a surgical robe, and you may receive sedation or local anesthesia to ensure comfort.
- Procedure: Using advanced imaging techniques, your provider will carefully guide a needle to the area around the targeted nerve. A combination of anesthetic and steroid medication is then injected to alleviate pain and reduce inflammation.
- Recovery: After the procedure, you’ll be monitored for a short time. Any mild soreness can typically be managed with over-the-counter pain relievers.
Insurance & Billing
Your eligibility for any procedure depends on the benefits outlined by your insurance provider, and our team at Nura will assist you with the authorization process.
Comprehensive Care
At Nura, we seamlessly integrate interventional procedures, physical therapy, psychological support and medications. Research shows that this comprehensive approach is the most effective way to manage chronic pain.
Find Pain Relief
Schedule an appointment with one of our pain specialists by filling out our appointment request form or giving us a call at 763-537-6000.
