FAQ’s on Epidural Steroid Injection (ESI) in Las Vegas

The epidural steroid injection (ESI) will decrease inflammation and pain of the spinal nerves and structures surrounding these nerves. One highly effective treatment option for low back pain relief is ESI.

What conditions are treated with the epidural steroid injection?

The epidural steroid injection is useful for the treatment of:

  • Herniated disc
  • Spinal stenosis
  • Degenerative disc disease

What medications does the doctor use for the ESI procedure?

The epidural steroid injection involves injection of betamethasone or triamcinolone. In addition, the pain specialist also uses an anesthetic, such as bupivacaine or lidocaine. The drugs are injected into the epidural space, which is between dural covering and the vertebra.

How does the steroid agent work?

Corticosteroids are used to reduce nerve inflammation, as well as inflammation of the nearby spinal structures. These medications cannot reverse damage to the spinal column or cure a herniated disc. However, the do provide pain relief that last for several months.

How do I prepare for the epidural steroid injection?

The ESI procedure only takes around 30 minutes. Once you arrive at the pain management center, a nurse will discuss the pros and cons of the procedure, and ask you to sign a consent form. The nurse places an IV catheter into your arm to administer fluids, a sedative, and other medications if necessary. Because you are not permitted to drive for 24 hours following the procedure, you should arrange to have someone drive you home.

What can I expect to happen during the ESI procedure?

The doctor will position you on your stomach, and an antiseptic solution is used to cleanse the skin. A small needle is used to inject a local anesthetic into the skin and deeper tissues. The ESI needle is positioned into the epidural space, which is done using real-time x-ray. If needed, the doctor will first flush inflammatory proteins from the epidural space before injecting the steroidal agent.

What happens after the epidural steroid injection?

A nurse will monitor you for around 20-30 minutes following the ESI procedure. We recommend that you rest for the remainder of the day, and gradually return to normal activities. Expect some mild soreness at the injection site, which only last for a couple of days and is relieved using ice packs.

Does the ESI procedure work?

The epidural steroid injection is useful for relief of back pain. According to recent clinical research studies, the procedure is around 90% effective. Most conditions require up to three ESIs for maximum effects, and these are often scheduled several weeks apart. According to research reports, ESI offers pain relief that lasts for 6-12 weeks.

What are the potential complications and risks associated with ESI?

The epidural steroid injection procedure is fairly safe, but there are some risks to consider. These include bleeding, infection, nerve damage, and dural puncture. In addition, corticosteroids have many side effects, such as increased appetite, high blood sugar, transient skin flushing, and a slight weight gain.

Who should NOT have the epidural steroid injection?

Not everyone is a candidate for the ESI. People who should avoid this procedure include those who:

  • Have an active infection
  • Are pregnant
  • Have uncontrolled heart disease or diabetes
  • Have allergies to certain medications used during the procedure

Resources

Botwin KP, Gruber RD, Bouchlas CG, et al. Fluoroscopically guided lumbar transformational epidural steroid injections in degenerative lumbar stenosis: an outcome study. Am J Phys Med Rehabil. Dec 2002;81(12):898-905.

Riew KD, Yin Y, Gilula L, et al. The effect of nerve-root injections on the need for operative treatment of lumbar radicular pain. A prospective, randomized, controlled, double-blind study. J Bone Joint Surg Am. Nov 2000;82-A(11):1589-93.

Riew KD, Park JB, Cho YS, et al. Nerve root blocks in the treatment of lumbar radicular pain. A minimum five-year follow-up. J Bone Joint Surg Am. Aug 2006;88(8):1722-

Vad VB, Bhat AL, Lutz GE, et al. Transforaminal epidural steroid injections in lumbosacral radiculopathy: a prospective randomized study. Spine. Jan 1 2002;27(1):11-6.