Epidural Steroid Injections

ESIs, or Epidural Steroid Injections, can help reduce joint pain in the area around an arthritic joint. While not a permanent solution by itself, Injecting a  corticosteroid into an arthritic joint space can drastically reduce pain and inflammation. The effects may last between 1 week to 1 year. Physicians usually employ Epidural Steroid Injections as a conservative measure before jumping to any surgical options.  Depending on the patient and ailment, ESIs may reduce pain to the point where physical therapy can take over, eliminating the need for further treatment. Ketamine may be used in some cases as an adjuvant medication during epidural steroid injections (ESIs), but it is not a standard or first-line medication for this procedure.

The Procedure:

  1. Preparation: The patient is positioned lying down, usually on their stomach or side, to expose the targeted spine area. The skin over the injection site is cleaned and sterilized.
  2. Local Anesthesia: A local anesthetic is administered to numb the skin and underlying tissues around the injection site. This helps minimize any discomfort during the procedure.
  3. Needle Placement: Using fluoroscopy (real-time X-ray guidance) or ultrasound imaging, the healthcare professional guides a thin needle into the epidural space. The needle is carefully advanced into the targeted area near the affected nerve root or spinal disc.
  4. Medication Injection: Once the needle is correctly positioned, a mixture of corticosteroid medication and sometimes a local anesthetic is injected into the epidural space. The corticosteroid aims to reduce inflammation, while the local anesthetic provides immediate pain relief.
  5. Post-Injection Care: After the injection, the patient may be monitored for a short period and then allowed to recover. The healthcare provider may provide instructions on post-injection care, such as rest, avoiding certain activities, or applying ice or heat to the injection site.

It’s important to note that while epidural steroid injections can provide temporary relief for many patients, the effects may vary. Some individuals may experience significant pain reduction and improved function, while others may have more modest or short-term benefits. The decision to pursue epidural steroid injections should be made in consultation with a healthcare professional, who can evaluate the individual’s condition, consider other treatment options, and determine the appropriateness of the procedure.


  • You might experience pain relief within a few days, as the corticosteroid’s anti-inflammatory effects take effect.
  • The duration of pain relief varies; some people experience relief for weeks to months.
  • Rest and avoiding strenuous activity for a day or two after the injection is generally recommended.
  • Discuss any concerns or unusual symptoms with your healthcare provider.

Risks and Considerations:

  • ESIs are generally safe, but like any medical procedure, they carry some risks, such as infection, nerve damage, or a temporary increase in pain.
  • Repeated injections should be spaced out to avoid potential complications.
  • ESIs might not provide complete pain relief for everyone, and their effectiveness can vary.

If you’re considering epidural steroid injections, consult with a healthcare provider who specializes in pain management. They can evaluate your condition, discuss potential benefits and risks, and determine if ESIs are a suitable treatment option for you.

Purpose and Benefits:

ESIs are used to provide temporary relief from pain, reduce inflammation, and improve mobility in various conditions, including:

  1. Herniated Disc: The injection can reduce inflammation around the herniated disc and alleviate pressure on the surrounding nerves.
  2. Spinal Stenosis: ESIs may help reduce inflammation and pain caused by the narrowing of the spinal canal.
  3. Degenerative Disc Disease: Injections can help manage pain and inflammation associated with degenerative changes in the spine.
  4. Sciatica: ESI can target inflammation and pressure on the sciatic nerve, which causes pain to radiate down the leg.
  5. Radiculopathy: Conditions causing nerve root irritation or compression can benefit from the anti-inflammatory effects of the injection.



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