Epidural Steroid Injections
Targeted relief for radicular pain, including sciatica
What is radicular pain?
Radicular pain starts when a spinal nerve root becomes inflamed or compressed. It travels along the path of the nerve, into the arm from the neck or down the leg from the low back (sciatica), and may come with numbness, tingling, or weakness.
Causes include disc herniation, narrowing of the openings where nerves exit the spine (foraminal stenosis), central spinal stenosis, and chemical irritation of the nerve root even without significant compression.
How epidural steroid injections work
Corticosteroid and local anesthetic are delivered to the epidural space near inflamed nerve roots, under live X-ray guidance with contrast to confirm precise placement. Depending on your symptoms, your physician will choose one of three approaches:
Transforaminal
Medication is placed at the opening where a specific nerve root exits the spine, for targeted relief of one or two nerve roots.
Interlaminar
Medication is placed in the epidural space from the back of the spine, spreading to nerve roots at and near the treated level.
Caudal
Medication is placed through a natural opening at the base of the spine, useful for lower lumbar and sacral nerve roots and after prior surgery.
Neck, mid back, and low back
Epidural injections can treat radicular pain at the cervical, thoracic, and lumbar levels.
What to expect
Before your procedure
Our team will review your medications, including blood thinners, and give you specific instructions. Plan to have someone drive you home if you receive sedation.
During your procedure
You lie on the procedure table while your skin is numbed. Using X-ray and contrast, your physician places the needle precisely and injects the medication. Most injections take 15 to 30 minutes.
After your procedure
Temporary numbness or a brief increase in pain is possible. The steroid usually starts working within 2 to 7 days. Injections are often paired with physical therapy and may be repeated if they help.
Part of a complete plan
Epidural injections are most effective as part of a broader treatment plan. By calming nerve inflammation, they can make it easier to stay active and take part in physical therapy while the underlying condition improves.
Are epidural steroid injections right for you?
They may be an option if:
- You have pain radiating into an arm or leg, with or without numbness or tingling
- Your symptoms haven't improved enough with medications, activity changes, or physical therapy
- Your exam and imaging point to an inflamed or compressed spinal nerve root
Our physicians will review your symptoms, exam, and imaging to determine whether this treatment is a good fit for you.
Risks
Risks include temporary soreness, a short-term increase in pain, headache, facial flushing, temporarily elevated blood sugar in people with diabetes, infection, bleeding, and rarely nerve injury. Your physician will review the risks with you before your procedure. Individual results vary.
Illustrations: Blausen.com staff, “Medical gallery of Blausen Medical 2014,” WikiJournal of Medicine, CC BY 3.0, cropped.