Epidural steroid injection



Epidural steroid injection (ESI) is a technique for relieving pain from spinal stenosis and spinal disc herniation. Using a needle, relatively small amounts of corticosteroids together with a local anesthetic are injected into the epidural space around the spinal cord and spinal nerves. The anti-inflammatory effect of the corticosteroid is responsible for providing pain relief when radiculopathy exists. Most studies point out that pain relief from ESI's are short term at best and do not reduce the need for surgical intervention. The evidence is mixed concerning the safety and efficacy of ESI therapy since all steroid injectates, no matter the manufacturer, are not FDA approved for epidural administration.

Modern techniques employ image guidance for accuracy. This allows the physician to visualize the location of the needle with respect to the anatomy prior to the injection. While traditional techniques without image guidance, also known as blind injections, can assure a degree of accuracy using anatomical landmarks, it has been shown in studies that image guidance provides much more reliable localization and accuracy in comparison.