Epidural Steroid Injections


ESIs are sometimes used to treat many forms of lower back pain and sciatica. The goal of injection is pain relief. If the initial injection is effective, the patient may have up to three injections in one-year period. ESIs are sometimes used to ease pain experienced in the cervical region (neck) and thoracic region (mid spine).https://www.nhs.uk/conditions/epidural/

The following conditions can cause acute or chronic lower back pain and/or sciatica and can be treated by ESIs:

  • Herniated disc – where the nucleus of the disc pushes through the outer ring (the annulus) and into the spinal canal where it pressures the spinal cord and nerves.
  • Lumbar spinal stenosis – a narrowing of he spinal canal.
  • Degenerative disc disease – where the collapse of the disc space may impinge on nerves in the lower back.
  • Compression fractures in the vertebra – where vertebral bone in the spine has decreased at least 15 to 20% in the height due to fracture.
  •  Cysts – which are in the facet joint or the nerve root and can expand to squeeze spine structures.
  • Annular tear – where a tear is present in the outer layer of the disc.

ESIs should not be performed on patients whose pain could be related to a spinal tumor. If spinal tumor is suspected, an MRI scan should be done prior to the injection to rule out a tumour. ESIs should also not be performed on patients with local or systematic infection and patients with bleeding problems (hemophilia patients).https://www.evidence.nhs.uk/search?q=epidural+steroid+injection


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