Reports show that 50 to 85% of adults experience back pain at some point, with a high prevalence in adults who are 65 years of age and older. One widely used treatment for low back and leg pain has been fluoroscopically guided epidural steroid injections (ESIs).

In basic terms, an epidural corticosteroid injection is a minimally invasive way to deliver anesthetic and anti-inflammatory medication into the body with a syringe. The medication is injected into the epidural space around the inflamed spinal nerves.

bThe level and length of pain relief can vary widely from patient to patient.

Illustration of the human back spine and rib cage, broken into puzzle pieces with one piece missing

Looking at an Epidural Corticosteroid Injection in More Depth

Epidural corticosteroid injections inject a small dose of anti-inflammatory medication, called a corticosteroid, into the lower back to relieve pain in your lower back or legs. The medication is injected into an area surrounding the nerves in the spine called the epidural space. The medication acts to reduce inflammation, and in doing so, it can help to relieve pain.

In addition to being a treatment, epidural corticosteroid injections can be used by your doctor to identify and diagnose specific nerve root problems.

What Are Steroids?

There are two kinds of steroids. One kind are chemicals, often hormones, that your body makes naturally. They help your organs, tissues and cells do their jobs.

There is also a class of man-made medicines called steroids. The two main types of the second kind of man-made steroids are corticosteroids and anabolic-androgenic steroids (or “anabolics”).

Corticosteroids are medicines that quickly fight inflammation in your body. These lab-made steroids work like natural hormone cortisol that is made by our adrenal glands. Cortisol keeps our immune systems from making substances that cause inflammation. Corticosteroid medicines work in a similar way. They slow or stop the immune system processes that trigger inflammation.

Limiting the Use of Corticosteroids

For some patients, epidural corticosteroid injections provide thankful pain relief. But they are usually limited to just a few a year because there’s a chance for systemic side effects. These can include skin thinning, facial flushing, insomnia, moodiness, and high blood sugar. In addition, it’s important that after injections you have enough of a break so that your body can return to its normal balance.

For these reasons your doctor will carefully weigh the scheduling of any successive corticosteroid injections.

The Epidural Corticosteroid Injection Procedure

An epidural corticosteroid injection is done on an outpatient basis. It takes approximately 10 to 30 minutes and patients are lying face down during the procedure.

The medicine is injected into the epidural space in your spine using x-ray moving image guidance (using a fluoroscope) on a screen so that it can be targeted precisely. A local anesthetic is also used to help with pain relief.

After the Procedure

After the procedure is completed, you can return home. Normally you can resume normal activities the following day. The corticosteroid usually starts working within 2 to 5 days, although you may need up to a week to feel the full benefits of the procedure.

Many people experience many months of pain relief and improved function after an injection. However, if you don’t experience pain relief you should contact your health care provider as this may be a sign that your pain is arising from other conditions.

Make an Appointment

Share This Page:

KING OF PRUSSIA, PA – Dr. Jeffery Rowe of Main Line Spine recently completed the first Minuteman® G3 procedure in Pennsylvania. The Minuteman® G3 was developed by Spinal Simplicity LLC as an innovative, minimally invasive, simple solution to treat complex spinal disorders.

Dr. Jeffrey Rowe, MD (center) stands between two colleagues after completing the first Spinal Simplicity G3 procedure in Pennsylvania.
Dr. Jeffrey Rowe, MD (center) stands between two colleagues after completing the first Spinal Simplicity G3 procedure in Pennsylvania.

The device is intended for the temporary fixation of the thoracic, lumbar and sacral spine while awaiting bony fusion to occur. It is designed for attachment to the posterior non-cervical spine at the spinous processes through its bilateral locking plates. It is intended for use with bone graft material placed within the device.

The Minuteman® G3 is indicated to treat patients with Degenerative Disc Disease, Lumbar Spinal Stenosis, and Spondylolisthesis. Generally, patients who could be eligible for Minuteman have not found lasting relief with conservative therapies like Physical Therapy, Epidural Steroid Injections, Medial Branch Blocks, and Radio Frequency Ablations.

Dr. Rowe views the Minuteman as one of the options he now considers to treat his patients’ back and leg pain.

Share This Page: