The epidural space is a space inside the spinal canal that surrounds the spinal cord and contains fluids, nerve roots, and other tissues. Injections of medications into the epidural space can be helpful in reducing nerve irritation and inflammation that can cause pain and other symptoms. Also called ESIs, epidural steroid injections are used most commonly to treat pain in the legs and arms that emanates from the lower back.
The nerves that provide sensation to every area of the body travel through the spine and exit at specific intervals, Sometimes, these nerves become compressed or “pinched,” resulting in pain and other symptoms. Epidural steroid injections deliver medications to relieve inflammation associated with nerve compressions resulting from arthritis, bone spurs, herniated discs, scoliosis, cysts, degenerative diseases, and injury. Because nerve endings are located in the epidural space, injecting anti-inflammatory and pain-relieving medications into this area can help relieve symptoms while also reducing the inflammation that can cause or exacerbate symptoms. Injections may be followed by physical therapy to help promote healing and improve range of motion, flexibility, and function.
Epidural steroid injections are performed on an outpatient basis using local anesthetics to numb the injection site, sometimes accompanied by light sedation to help the patient relax. The injection site is carefully cleansed, then the needle is inserted into the epidural space using a special x-ray to guide its placement. Once the needle is properly positioned, the medication is injected and the needle is removed. A small bandage will be placed over the injection site, and patients will spend a brief period of time in a recovery area before being discharged. most patients can resume their regular activities the next day with relief of symptoms occurring from one to three days after the procedure.