Epidural Steroid Injection (ESI)
An Epidural Steroid Injection is a treatment for pain caused by inflamed and irritated spinal nerves. Medication is put into the fatty cushion layer that surrounds the spinal nerve roots and lines the spinal canal. X-ray dye is injected to be sure the needle is positioned correctly for the area to be treated. Medications injected include a steroid (long-acting cortisone type medication) and a local anesthetic. The actions of these medications are to reduce pain, inflammation and swelling. The local anesthetic may provide immediate, but brief relief. The steroid can take anywhere from a few days to a week to start working, and is intended to provide extended relief. A second or third injection may be needed to obtain maximum benefit if symptoms are improving, but not fully resolved after one treatment. Physical therapy and/or other conservative treatments may also be recommended. If a repeat injection is needed, it may be done after two to three weeks.