An epidural steroid injection (ESI) is a procedure that can be done to help relieve neck, arm, back, and leg pain caused by inflamed spinal nerves. An epidural steroid injection can be performed to relieve pain due to spondylolysis, spinal stenosis, or disc herniation. Medicines are delivered to the spinal nerves through the epidural space, the area between the protective covering of the spinal cord and vertebrae. Steroid injections can reduce inflammation and are effective when delivered into the painful area. Epidural steroid injections can also help determine if surgery might be beneficial for pain associated with a herniated disc. Many patients experience pain relief from multiple injections. Pain relief from injections may last for several days or even several years. There are 4 areas an ESI can be performed on. A cervical epidural steroid injection is performed for pain associated with the neck, shoulder, and arms. A thoracic epidural steroid injection can be performed to gain relief from pain in the mid-back or the rib cage. A lumbar epidural steroid injection is done for many forms of low back pain and leg pain. The caudal epidural steroid injection is located at the base of the spine, above the tailbone. It is also performed to alleviate low back pain and leg pain. The caudal approach is especially useful in those patients who have previously undergone low back surgery. This approach is also optimal in patients who are anti-coagulated. With few risks, epidural steroid injections are considered an appropriate non-surgical treatment.
The caudal approach to the epidural space involves the use of a Tuohy needle, an intravenous catheter, or a hypodermic needle to puncture the sacrococcygeal membrane . Injecting local anaesthetic at this level can result in analgesia and/or anaesthesia of the perineum and groin areas. The caudal epidural technique is often used in infants and children undergoing surgery involving the groin, pelvis or lower extremities. In this population, caudal epidural analgesia is usually combined with general anaesthesia since most children do not tolerate surgery when regional anaesthesia is employed as the sole modality.
Corticosteroid side effects may cause weight gain, water retention, flushing (hot flashes), mood swings or insomnia, and elevated blood sugar levels in people with diabetes. Any numbness or mild muscle weakness usually resolves within 8 hours in the affected arm or leg (similar to the facial numbness experienced after dental work). Patients who are being treated for chronic conditions (., heart disease, diabetes, rheumatoid arthritis) or those who cannot temporarily discontinue anti-clotting medications should consult their personal physician for a risk assessment.