Interlaminar Epidural Steroid Injection (ESI)
Treating Pain in Residents of North Central Arkansas & South Central Missouri
Epidural Steroid Injections (ESI) are fairly painless procedures that utilize
tiny needles. They are usually used to treat acute and chronic pain conditions
in patients. ESIs are generally utilized to help lessen inflammation and
irritation around specific groups of nerves in the neck area, mid-back
area, and lower back area. These nerves can produce radicular pain when
they are irritated. Radicular pain is a specific type of pain that travels
along the nerve and you can feel it in your limbs, around your chest,
and in your hips. This type of pain is usually described as an aching,
burning, tingling, or shooting, numbness or electricity.
Several medical conditions commonly treated by way of ESI are:
- Stenosis: Spinal canal or nerve root exits are narrowed
- Failed back surgery syndrome: Pain that is felt even after a spinal surgery
- Degenerative disk disease
- Bulging or herniated disks
- Radiculopathy: Pain that moves down your arms or legs
On the day of your appointment, please arrive 20 minutes prior to your
procedure’s start time. Our skilled nurses will begin an IV if you
want sedation and they will then conduct a nurse pre-operation assessment.
You will be directed to lay down on a hospital bed in the procedure room.
To make you more comfortable, you will be provided nitrous oxide gas and
sedation. To lessen the chance of infection, we place a cold cleaning
solution on our patients. Utilizing x-ray guidance, your doctor will identify
the procedure site and give you a shot of numbing medication. This shot
may sting slightly, but the pain should pass quickly. Your doctor will
then place the epidural needle into the epidural space by utilizing the
x-ray’s guidance. The needle will inject dye in order to confirm
proper placement of the needle. The needle will inject medication made
up of a steroid and bupivacaine to cover all the affected nerve fibers.
This, in turn, should reduce the pain levels and reduce inflammation in
the procedure site. Most patients say the feeling is similar to warm water
being run over their back or legs. This is expected and is a good sign
that the needle was placed properly. We then remove the needle, take you
to a recovery room, and observe you for 15 minutes to make sure everything
went according to plan. The procedure itself only takes about 15 minutes,
and you will be allowed to return home after we are done observing you.
What to Expect Afterwards
The medication’s effects usually start working in three to five days,
but it can sometimes take up to a week to feel the full benefits. Most
of the time patients report feeling relief from their radicular pain first.
This is common and expected. Many patients say they feel less pain and
are able to engage in more physical activities as a result. The medication
usually has limited side effects, but some patients may experience anxiety,
trouble falling asleep, temporary water retention, or changes in their
menstrual cycles. If you are diabetic, you may experience elevated blood
sugar levels for a couple days. Fortunately, these side effects are generally
very mild and will often clear up within several days.
ESIs have been perfected over the past several decades and are typically
considered a safe and effective way to treat acute and chronic pain conditions.
Medical complications are rare but they could include allergic reactions,
bleeding, infections, headaches, paralysis, and damage of the nerves.
Although not all patients experience total pain relief with ESIs, the
injections frequently reduce the level of pain and allow for improved
functionality. Your initial round of epidural injections can be completed
in a set of three injections three weeks apart. If you feel that the ESIs
are significantly helping reduce your pain and inflammation, you can have
repeated and periodic injections to maintain the pain improvements. ESIs
are usually used in conjunction with other treatments in order to try
and maximize the procedure’s medical benefits.
For more information on epidural steroid injections, please call Interventional
Pain Management, a department of BRMC, at (870) 508-5900.