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Epidural Steroid Injection

Epidural steroid injections or ESI’s is a fairly common injection of medicine into the space that runs along the back of the spinal canal. This steroid injection can help identify the source of your pain and can reduce inflammation; resulting pain relief may last for several days or even years. It is often used to treat pain in the neck, back or side that sometimes radiates into your limbs from the site of a pinched or inflamed nerve. The goal is to reduce your pain so that you may resume normal activities and/or a physical therapy program.

The following video may give you a better idea of what to expect, there is also more information about this procedure below. 




  • We will call you prior to your appointment to discuss specific preparation instructions, risks, medications you may be taking and your past imaging exams.
  • Please make arrangements to have someone drive you to and from the office or outpatient center the day of the injection.

You may be asked to change into a hospital gown. An epidural steroid injection usually takes between 15 and 30 minutes, however, you will be asked to wait an additional 15-30 minutes after the procedure so that the our staff can monitor your symptoms.  Expect to budget about an hour of your time from check in to completion.

Here’s what will happen:

  • You will lie on an x-ray table and the skin in the targeted area will be cleaned and then numbed with a local anesthetic similar to what a dentist uses
  • Using fluoroscopy (live x-ray) for guidance, a needle is inserted into the skin and directed toward the epidural space. Fluoroscopy helps increase the precision of the injection.
  • The specialized radiologist injects  contrast material into, or adjacent to, the epidural space thought to be causing your pain, highlighting the space to guide the steroid injection
  • Then the radiologist slowly releases a combination of anti-inflammatory (steroid) and anesthetic (numbing) medications into the epidural space 

The procedure can cause some discomfort. If indicated, we numb the skin and deeper tissues with a local anesthetic prior to the epidural injection. Usually you feel strong pressure and not much pain.

The radiologist will review your images and provide your doctor with a detailed report. Immediately following the injection you may experience temporary weakness and numbness in your limbs. Inflammation and pain relief may occur following the injection. Peak pain relief should occur within a few days and the benefits can last for many weeks. The exact timing, however, varies from patient to patient.

Although complications are rare, we will review possible side effects and risks with you prior to your exam so you can ask questions and decide if this exam is right for you.