Epidural Steroid Injections


Epidural steroid injections, also known as an ESI in the medical field, are an effective treatment method used to reduce pain by applying different steroid treatment directly to the affected area. There are three different steroids used for epidural steroid injections, and the injection also includes a local anesthetic, which offers immediate relief from the pain present within the spinal cord, surrounding space, and the nerves.

Benefits and Outcomes

The use of an epidural steroid injection is generally provided to a patient after they have tried other methods of non-surgical treatment, but have not experienced any type of relief from the therapy. The ESI method of treatment is preferred before invasive surgical procedures, because the injections can offer some with complete pain relief right away, and there is no extensive healing time.

For most people, the epidural steroid injection is effective in reducing or completely eliminating the patient’s pain. While the steroids that are injected into the back take a longer time to have an effect, when used in conjunction with a local anesthetic (like lidocaine), the pain is eliminated immediately. This type of combination therapy works by offering both short- and long-term relief.

Anesthetic: When the epidural injection is made, it will start to numb the area where pain is present upon contact. While this will only provide pain relief for about 24 hours, by the time the anesthetic begins to wear off, the steroid will start to take effect.

Steroid: This part of the injection may take up to 72 hours to be completely effective, but most patients have stated that pain relief is completely obtained within the first 24-48 hours. The steroid works to reduce the inflammation that is present completely, and it can be effective in reducing pain for three weeks. However, each patient will have unique results.

The ESI treatment is generally completed within 45 minutes, after imaging tests are used to find the proper area for the injection. The injection is placed within the area of the spine called the epidural sack, and the medications do not go into the thecal sac, which contains the spinal cord and the roots. Prior to the epidural steroid injection, the use of an MRI, CT, X-RAY, or advanced techniques are used to determine if the pain is occurring within the spinal disk, or another specific area. The most advanced methods used today are able to recognize the affected area easily, so the risk of improper treatment is greatly reduced.

If the epidural injections are effective in providing pain relief for the patient, they can be provided on an on-going basis. Generally, no more than three shots within a 12 month period are recommended. However, if there is a need for more than three injections, alternative options should be explored as an effective treatment.

Conditions Treated with Epidural Steroid Injections

The use of epidural steroid injections is common when pain is present due to injury to a disk, such as:

  • Degenerated disc disease (DDD)
  • A bulging disk
  • Symptoms of osteoarthritis
  • Joint conditions
  • Injury of the spine
  • Tumors of the spine
  • Congenital conditions related to birth defects, such as a narrowed spinal column

The ESI treatment is also effective for pain that occurs outside of the back, such as inflammation and pain within the legs due to an accident or that which is related to a nerve. Both nerve and tissue pain can be relieved with the use of epidural spinal injections.


Epidural steroid injections can treat pain that is found within the neck, which may be dull or radiating. In some cases, the injections will relieve the pain to an extent, but it may not be reduced enough to provide the patient with relief, or the condition may progress, which can lead to further damage. In this type of situation, the physician will generally decide upon a surgical procedure that can be used to reduce or eliminate pain for good.


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