What to Know About Epidural Steroid Injections

John K. Hong, M.D. | 4/24/2025

📌 What Are Epidural Steroid Injections?

Epidural steroid injections (ESIs) are a widely used, minimally invasive treatment designed to reduce inflammation and relieve pain in the spine. They are commonly used for patients experiencing chronic back pain, neck pain, or radiating nerve pain, often due to disc herniation, spinal stenosis, or degenerative disc disease.

The procedure involves injecting a corticosteroid and often a local anesthetic into the epidural space—the area around the spinal cord and nerves—targeting inflammation directly at its source.

💡 What Conditions Can ESIs Help?

ESIs are commonly used for:

• Herniated or bulging discs

• Lumbar or cervical radiculopathy (sciatica, arm pain)

• Spinal stenosis

• Degenerative disc disease

• Post-surgical spine syndromes

• Spondylolisthesis

  
  

Patients often experience radiating pain, numbness, or tingling that travels down the legs or arms. ESIs are designed to reduce this inflammation and create a window for improved function and physical therapy.

💉 How Is the Procedure Performed?

1. Preparation: The patient lies on an X-ray table. A local anesthetic numbs the skin.

2. Guided Placement: Using fluoroscopic (X-ray) guidance, the physician inserts a needle into the epidural space.

3. Injection: A combination of corticosteroid and anesthetic is slowly injected.

4. Recovery: The procedure typically takes 5–10 minutes. Patients are observed briefly and discharged the same day.

   
   

There are three common approaches:

• Interlaminar: Injected between the vertebrae

• Transforaminal: Directed toward the specific nerve root

• Caudal: Entering the lowest part of the epidural space

  
  

⏱️ How Long Do Results Last?

• Some patients feel relief within a few days, while others may take a week or two.

• Pain relief may last weeks to months, and in some cases, significantly longer.

• A series of injections is no longer standard of care. The effect of each injection will determine the next step, which may include a repeat injection.

  
  

✅ Benefits

• Minimally invasive

• Performed in an outpatient setting

• Reduces inflammation at the source

• May delay or prevent the need for surgery

• Allows for more effective physical therapy participation

  
  

⚠️ Risks and Considerations

Though ESIs are generally safe, potential risks include:

• Temporary increase in pain

• Headache

• Infection (rare)

• Bleeding or nerve injury (extremely rare)

• Elevation in blood sugar or blood pressure in some patients

  
  

Patients with diabetes, hypertension, or bleeding disorders should discuss these with their provider beforehand.

👨‍⚕️ Who Should Perform This Procedure?

Epidural injections should be performed by a board-certified interventional pain physician or spine specialist with training in fluoroscopic-guided spinal procedures to ensure safety and accuracy.

📝 Final Thoughts

Epidural steroid injections are a time-tested, well-tolerated option for managing spine-related pain. While not a cure, they are an important part of a comprehensive pain management strategy, especially when paired with physical therapy, lifestyle changes, and appropriate diagnostics.

If you're struggling with persistent back or neck pain, an ESI might be the next step toward getting your life back on track.

Interested in learning whether you're a candidate for an ESI? Contact us for a consultation and personalized treatment plan.

For more information or to schedule a consultation, contact our clinic today at (435) 714-7180. Parkview has offices in Park City and Salt Lake City to conveniently serve you!