Epidural Steroid Injections

Epidural steroid injections

Cervical Epidural Steroid Injection
Caudal Steroid Injection
Lumbar Epidural Steroid Injection
Lumbar Transforaminal Epidural Steroid Injection

Epidural steroid injections are the most common procedure we do. The underlying idea is that by bathing an inflamed nerve root in steroids, which are anti-inflammatories, we can decrease the irritation of the nerve root which is causing pain. They are most commonly used in situations of radicular pain, when the pain goes down the leg.

The nerve root is most often irritated by an inflamed disc touching the nerve or by chemicals which normally occur in the disc leaking out and irritating the disc:

Drawing of a disc herniation compressing the nerve root.

The procedure is quick and simple. While most people are concerned prior to the procedure, the most common response we have afterwards is, “Is that all?”

What we are doing during an epidural steroid injection is very simple. The spinal cord goes through the spinal canal, giving off nerve roots as it goes. The cord is protected by Cerebral Spinal Fluid (CSF), which serves as a shock absorber for the cord. The CSF is held in place by a membrane with several layers, one of which is called the Dura, from the Greek for tough (think of “durable”.) The Greek word "epi" means outside of, so the epidural space is outside of this tough membrane. We can enter the epidural space and deposit small amounts of long-lasting steroids, so that we have specifically targeted the inflamed area and treated it with maximal amounts of steroids, while avoiding exposing the rest of the body to the steroids.

Transforaminal Epidural Steroid Injection