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Epidural Steroid Injections

If you are experiencing lower back and radiating nerve pain an Epidural Steroid Injection (ESI) may be an effective nonsurgical treatment option. Epidural steroid injections are powerful anti-inflammatories that reduce nerve inflammation at the disc nerve interface, "the source." Epidurals wash the nerve root in a mixture of steroid and local anesthetic to reduce swelling. They may hasten the recovery time by reducing nerve irritation and edema around the disc herniation. It is important to note however, that epidurals do not resolve disc herniation, they merely treat neuropathic pain caused by the herniation.

Your pain management specialist or physiatrist, will use X-ray and contrast to safely and accurately inject the epidural.

Common reasons to utilize Epidural Steroid Injections include:

  • Commonly used to relieve back pain when a mechanical spine nerve irritation is the cause.
  • Used for exacerbations of radicular and nonradicular pain from nerve inflammation.
  • When combined with Physical Therapy and NSAIDs (non-steroidal anti-inflammatory drugs), Epidural Steroid Injections can often delay or prevent surgical treatments.

Different Types of Epidural Steroid Injections:

  • Intralaminar Epidural Steroid Injection is the most common technique for large spread. It is commonly used to treat spinal stenosis for lower back pain. Given there is wide coverage, this is used for less specific areas. There is risk of dural puncture with this procedure.
  • Transforaminal Epidural Steroid Injection is used when placement is at a more specific level. The steroid is placed at the disc nerve interface. This type of epidural is used for selective acute radicular pain. There is a risk of transient neuritis with this procedure.
  • Caudal Epidural Steroid Injection is are given in the coccyx (tailbone or caudal) region to treat chronic lower back pain and chronic pain in the legs, an injection to the lowest part of the epidural space. A caudal steroid injection can help reduce lower back and leg pain caused sciatica, herniated discs, bone spurs or other back problems. Possible risks include bleeding or infection at the injection site or possibly a headache if the dura is punctured, which is unusual.
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  • Interventional Procedure "Dr. Safman is caring and communicates well. The discomfort from the spinal injection is very minor. She makes it an easy procedure." Provider: Kimberly Safman MD
  • Spinal Injections Epidural/Facet "Her compassion and expertise. Her team is very caring and efficient." Provider: Kimberly Safman MD
  • Spinal Injections Epidural/Facet "My pain is gone right now. Explains everything she is doing." Provider: Kimberly Safman MD
  • Spinal Injections Epidural/Facet "They make you feel comfortable during your procedure and are very compassionate." Provider: Balaji (Bobby) S Charlu MD
  • Spinal Injections Epidural/Facet "The exam was very caring, helpful and professional." Provider: Balaji (Bobby) S Charlu MD
  • Spinal Injections Epidural/Facet "I felt that everyone was very competent and professional and that I was in good hands." Provider: Kimberly Safman MD
  • Spinal Injections Epidural/Facet "The x-ray tech was very nice and of course Dr Safman was super." Provider: Balaji (Bobby) S Charlu MD
  • Spinal Injections Epidural/Facet "It's clear to me that Dr. Charlu is extremely good at what he does, and truly cares for me. The team is always upbeat, kind, anxious, and able to help me." Provider: Balaji (Bobby) S Charlu MD
  • Spinal Injections Epidural/Facet "Everyone was friendly and showed concern for my problems. My questions were answered and my condition was monitored." Provider: Kimberly Safman MD
  • Spinal Injections Epidural/Facet "Dr Safman and her team were extremely attentive and professional. They made every attempt to see that I was comfortable and at ease with the procedure. I have the utmost confidence in Dr Safman and her associates. Plus, they have a great sense of humor w ..." Provider: Kimberly Safman MD
  • Spinal Injections Epidural/Facet "I think Dr. Safman is an excellent clinician. I totally trust her sticking long needles into me. She is good at explaining what she is doing and at asking how you are doing during the course of the treatment." Provider: Kimberly Safman MD
  • Spinal Injections Epidural/Facet "Her individualized personal and professional care really helps." Provider: Kimberly Safman MD
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