Epidural Steroid Injection
Epidural steroid injections, or ESIs, deliver anti-inflammatory medicine into the “epidural space” of the spine – the space outside of the sac of fluid around your spinal cord.
If you’re dealing with pain that spreads from your lower spine down into the hips or legs, your pain management physician may recommend an ESI to help you manage your pain. This pain is typically caused by pressure being placed on a nerve as it leaves the spine, often caused by a bulging disk.
Epidural steroid injections are very common for managing radicular pain but are only used when your pain level has not improved with other interventions, like medicines, physical therapy, or other nonsurgical treatments. Back pain is the fifth most common reason people seek medical care in the U.S., with approximately 9% to 25% of people reporting low back pain with leg pain traveling below the knee every year.
At Pain Specialists of Charleston, our board-certified pain management physicians will examine, diagnose, and treat the root cause of your pain. Our team is focused on helping you reclaim your quality of life – not just treating your symptoms.
For epidural steroid injections in Charleston, SC, we are here to help! Our pain management clinic is open five days a week, and we are accepting new patients. Schedule your appointment with us today – no referral needed!
WHAT CAN IT TREAT
General Back Pain
- Axial back pain (Localized lower back pain): This pain can be described as sharp or dull in the lower back, occurring constantly or occasionally.
- Back pain: This common type of back pain is described as general pain in the back area.
- Spinal pain: Pain localized along the spine.
Conditions Affecting the Spine
- Lumbar degenerative disk disease: This occurs when the cushioning between vertebrae in the lower back wears down, resulting in inflammation and pain.
- Lumbar herniated disk (slipped, ruptured, or bulging disk): This condition occurs when a disk in the lower back bulges from its normal position and presses on the nearby nerves.
- Lumbar osteoarthritis (lumbar spondylosis): This condition is typically due to aging, resulting in wear-and-tear changes in the joints, disks, and bones of the lower back.
- Lumbar spinal stenosis: This condition involves the narrowing of the spaces in the lower spine, causing pinched nerves and pain. This pain is felt mainly when walking or standing.
Nerve-Related Pain
- Lumbar radicular pain (sciatica): Known as sciatica, this condition consists of the feeling of pain radiating from the lower back down to the legs.
- Neurogenic claudication: This condition involves tingling or pain in the lower back, legs, hips, or buttocks. It is often felt when standing up or walking because of the compressed spinal nerves.
POSSIBLE SIDE EFFECTS
Mild Side Effects
- Dizziness
- Headache
- Nausea
- Pain at the injection site
- Irritability
- Insomnia
- Increased blood sugar
More Severe Side Effects
- Allergic reaction
- Bleeding
- Nerve damage
- Infection
- Paralysis
Rare Serious Complications
- Blood clots inside the spine
- Infection around the spine or brain
- Nerve damage
- Paralysis
POSSIBLE RISKS
Rare but Serious Risks
- Allergic reaction: Some people have reported an allergic reaction to the medication used.
- Bleeding around the spinal column (hematoma): In some rare cases, bleeding near the spine can occur.
- Difficulty breathing: If the injection was given in the neck, it may result in some difficulty with breathing.
- Infection: An infection may develop in or around the spine, such as an abscess or meningitis.
- Nerve root damage: This can result in increased leg pain.
- Rare brain and nervous system problems: There is a very small chance of serious issues that can affect the brain or nervous system.
WHAT TO EXPECT BEFORE THE PROCEDURE
Initial Assessment Steps
- Analyze overall health: Review medical conditions, current medications, and any allergies.
- Check your spine: A physical exam can help our pain management team pinpoint the area causing pain and rule out other possible causes.
- Conduct imaging tests: Your pain management physician may utilize imaging or lab tests to look for joint damage or inflammation.
Information to Share with Your Doctor
- Pregnancy status: Communicate with your doctor if you are pregnant or could be pregnant.
- Medications: Brief your doctor on all medications you’re taking, including herbs, supplements, and over-the-counter drugs.
Medication Instructions
- Blood thinners: Your doctor may ask you to temporarily stop taking blood thinners like aspirin, ibuprofen (Advil, Motrin), clopidogrel (Plavix), warfarin (Coumadin, Jantoven), naproxen (Aleve, Naprosyn), and heparin before the procedure.
DAY OF THE PROCEDURE
Setting and Duration
- Outpatient procedure: The injection is done in an outpatient setting, so you won’t have to stay overnight.
- Awake and alert: You don’t have to be put under for the injection, you will be awake during the procedure.
Procedure Steps
- Guidance by X-ray: Your pain management physician will use an X-ray machine to see the moving images on a screen. This helps guide the needle to the correct spot for your injection.
- Contrast dye: A special dye is injected at the site to confirm the medicine will go exactly where it is supposed to go.
- Injecting the steroid: The provider will inject the steroid medicine, typically mixed with a local anesthetic to help relieve pain.
AFTER THE PROCEDURE
Discomfort and Recovery
- Mild discomfort: You may experience some soreness where the needle was inserted, but this should only last a few hours.
- Resting recommended: Your doctor may advise you to take it easy for the rest of the day.
- Initial pain increase: Your pain could get worse for two to three days following the injection, as the steroid takes time to work. It will begin to improve after that.
Transportation
- Arrange a ride: If you took medication to help make you sleepy during the procedure, be sure to have someone to drive you home.
Keeping a Pain Journal
- Document symptoms: On the day of the injection, write down any changes in your pain. This will help your doctor get a better understanding of how well the procedure worked.
Consult with Your Doctor
- Ask questions: Contact your physician or pain management team if you have any questions or concerns about your pain levels or the procedure.
WHEN SHOULD I SEE A PAIN PHYSICIAN
If you’ve been dealing with chronic back pain or pain near your spine, it’s time to meet with a pain management physician. At Pain Specialists of Charleston, our board-certified pain management physicians will examine, diagnose, and treat the root cause of your pain, so you can get back to feeling like yourself again.
We are open five days a week and are accepting new patients. Schedule your appointment with us today – no referral needed!
Request Appointment | Contact Us | Meet Pain Doctors
CONDITIONS WE MANAGE
- KNEE PAIN
- CHEST PAIN
- SHOULDER PAIN
- BACK PAIN
- HIP PAIN
- NECK PAIN
- ELBOW PAIN
- FOOT PAIN
- WRIST PAIN
- & MORE!
TREATMENT WE OFFER
At Pain Specialists of Charleston, our board-certified team offers pain management treatment in the form of:
- Epidural Steroid Injection including cervical, thoracic, and lumbar injections
- Joint Injections including knee, shoulder, and hip injections
- Caudal Epidural Injection
- Hip Joint Injection
- Lumbar Sympathetic Block
- Facet Joint Injection
- Medial Branch Block
- Radiofrequency Ablation (Rhizotomy)
- Sacroiliac Joint Injection
- Discography
- Neurostimulation, also known as Spinal Cord Stimulation
- Stellate Ganglion Block
- Transforaminal Selective Nerve Root Block Injection
- Medical Massage Therapy
- Clinical Trials
- …and MORE!
ABOUT PAIN SPECIALISTS OF CHARLESTON
At Pain Specialists of Charleston, our mission is to provide you with relief from your chronic pain through the latest, most innovative pain management treatments available. Whether you’re suffering from back pain, whiplash, or anything in between, we can help you get back to feeling like yourself once again.
Plus, no referral is necessary!
At our pain management clinic, our experienced team approaches your pain through a variety of services to best meet your needs. This includes anesthesiology, neurology, psychology, and nursing. Our providers believe in collaborating with your healthcare team – your primary care physician, specialists, chiropractor, physical therapist, and especially you, the patient, to bring you the care you need.
Our private practice is powered by a talented, carefully selected leadership team.
MEET DOCTOR EDWARD M. TAVEL, JR., MD
- Over 20+ Years of Specialty Training
- Double-Board Certified in Anesthesiology and Pain Management
AWARDS & ASSOCIATIONS
AS SEEN ON
FAQs
Who should get an epidural steroid injection?
If you’re experiencing intense, hard-to-treat, pain in your back or limbs from your spinal nerves, then ask your pain management physician about epidural steroid injections (ESIs). They may give you the quick relief you need from narrowed nerve passages in the spine causing you pain.
Narrowed nerve passages can be a result of herniated disks, slipped vertebrae, joint cysts, bone spurs, and thickening ligaments due to spinal arthritis. Epidural steroid injections can help reduce the inflammation of the nerves and improve pain levels. Talk to your doctor about ESIs or contact our pain management clinic in Charleston today!
Who should NOT get an epidural steroid injection?
Those who should not get an epidural steroid injection (ESI) include people who are dealing with:
- Bleeding problems: ESIs can cause bleeding.
- Infection: ESIs should not be performed on anyone with an infection.
- Pregnancy: Fluoroscopy X-rays, which may be used during the procedure, can be harmful to a pregnancy.
Other conditions that may require you to discuss the effects of an ESI with your doctor include diabetes (ESIs can slightly raise blood sugar levels), glaucoma (ESIs can temporarily raise eye pressure), and blood thinner usage (can increase the risk of complications).
What are some of the risks of taking an epidural steroid injection?
Epidural steroid injections typically cause no issues. Side effects that can occur include “steroid flush” which is the flushing of the face and the chest, including warmth and an increase in temperature, sleep issues, menstrual changes, water retention, and anxiety.
In rare cases, increased pain for several days after the procedure can occur. Rare but serious complications can include an allergic reaction, bleeding, infection, nerve damage, and paralysis.
How painful are ESIs?
Epidural steroid injections are typically not painful.
During the procedure, you may experience some pressure or a minor pinch. This injection needs to be very precise, so it is very important to keep still during the procedure. Your pain management physician will keep you under observation for 20 minutes following the procedure, then you’ll be able to go home and rest.
Are you sedated for ESIs?
It depends on the individual patient.
You can choose to be sedated for your injection, or you can have the procedure without any sedation. An epidural steroid injection is typically not painful and well tolerated, and you can usually return to work the next day – and even the same day depending on your doctor’s recommendations. Talk to your pain management physician before the procedure to get the most accurate information for your needs.
Are epidural steroid injections safe?
Epidural steroid injections are a relatively safe and common procedure, with minimal pain associated with it.
Like any other medical treatment, there are some risks of complications. Mild side effects can include dizziness, headache, nausea, pain at the injection site, insomnia, irritability, and higher blood sugar. More severe side effects from the injection can include an allergic reaction, nerve damage, infection, bleeding, and paralysis.
Are ESIs worth it?
For those suffering from chronic low back pain, especially if the pain is a result of a herniated disc or spinal stenosis, epidural steroid injections (ESIs) may be worth it. The side effects of ESIs can vary from patient to patient, so it’s important to talk to your doctor about their effectiveness for your needs.
What is the difference between an epidural injection and a facet joint injection?
Epidural steroid injections, or ESIs, mainly treat pain radiating from the spine to other parts of the back or the limbs. It’s typically used to manage pain caused by a specific nerve becoming inflamed or pinched.
Facet joint injections are used to treat pain around the small joints in the spine that allow it to bend and twist while keeping the spine from twisting too much or slipping forward. These small joints are called facet joints.
How successful are epidural steroid injections?
Epidural steroid injections (ESIs) are a very common type of therapy to treat and manage back and spinal pain. Approximately more than 50% of pain reduction was experienced in patients following their first injection.
Can I return to normal daily activity after an epidural steroid injection?
Yes! Typically, you can return to your normal after your epidural steroid injection.
Following the procedure, avoid driving for at least 12 hours and avoid heavy lifting. You might feel a bit unsteady, so take it slow and don’t walk too much or too far right away. Continue your regular diet and medications as normal, and you can expect pain relief from the injection in about one to three days after the procedure. It may take up to two weeks for the peak effect to take place.
How long do the results last?
The length of the results from the epidural steroid injection depends on the patient.
Epidural steroid injections (ESIs) are typically most effective in the short- to medium-term – approximately six to 12 months of pain relief. If your pain management physician can locate the root of your pain, you may experience more success. Additional diagnosis and examination with your pain management team may be necessary to determine the root cause and locate it to resolve your pain.
How common are complications after taking epidural steroids?
Complications from epidural steroid injections (ESIs) are very rare. The National Library of Medicine reports less than 2.4% of patients experience any complications from the ESIs. This procedure is relatively safe and very common.
What is the next step if epidural steroid injections don’t offer enough pain relief?
If an epidural steroid injection (ESI) doesn’t offer enough relief, we suggest you consult with a pain management specialist. They may be able to provide additional treatment options and help you develop a more comprehensive plan to manage your pain.
Pain Specialists of Charleston offer board-certified physicians in anesthesiology, neurology, psychology, and nursing. Our clinic offers a full exam during the initial visit to help you get to the root cause of your pain. If you’re interested in chronic pain relief, you can schedule an appointment. No referral needed and accepting new patients today!
What is an epidural steroid injection (ESI)?
An epidural steroid injection is a procedure involving the injection of a corticosteroid or steroid into the epidural space to treat your chronic back pain. Epidural space consists of the area around your spinal cord and outside the sac of fluid containing spinal fluid.
