Epidural Injection

An c is one of the most advanced and successful treatment methods. The Epidural Steroid Injection (ESI) is a minimally invasive procedure and mainly used to relieve neck, arm, back and leg pain which is caused by inflammation of spinal nerves due to Spinal Stenosis or Disc Herniation. Epidural Injection provides temporary or permanent relief from pain. The major goal of Epidural Injection treatment is to reduce or control pain so that patient can resume normal activities and a physical therapy program.

Epidural Space is the area between the bony vertebra and the protective dura sac surrounding the spinal nerves and cord. The epidural space is the outermost part of the spinal canal. An Epidural Steroid Injection includes both a corticosteroid and an anesthetic numbing agent. Steroids, anesthetics and anti-inflammatory medications are typically delivered in an epidural injection to provide temporary or prolonged relief from pain or inflammation. The epidural injection reduces pain as well as swelling in and around the spinal nerve roots.

CT scan is very helpful for the Spine Specialist doctors to place the needle in exactly right location to target the specific area causing the pain so that patient can get maximum benefit from the injection.

Common Uses of Epidural Injection

 An Epidural Injection is one of most effective method used to relieve pain. An epidural injection is given to reduce pain caused by conditions such as:

  • A HerniatedDisk that affect nerves causing pain
  • Spinal Stenosis
  • Chronic back or leg pain after spinal surgery
  • Other injuries to spinal nerves, vertebrae and surrounding tissues
  • Bone spurs

Types of Epidural Injections

Cervical ESI (Neck)

In this type, the needle entry site is from the side of neck to reach the neural foramen and just above the opening for the nerve root and outside the epidural space.

Lumbar ESI (Low Back)

In this type, the needle entry site is slightly off midline of the back to reach the nerve canal.

Caudal ESI (tailbone)

 In Caudal ESI, the needle is placed in the sacral hiatus above the tailbone to reach the lowest spinal nerves.

Preparation of Epidural Injection Treatment


  • Before undergoing Epidural Injection treatment, doctor gives specific instructions to every patient about the changes in regular medicines schedule.
  • Doctor reviews patient’s medical history and previous imaging studies to decide the best approach for the injections.
  • Doctor also asks patients to avoid eating or drinking anything for several hours before epidural injection procedure to prevent stomach upset after the injection.
  • This procedure is usually performed in an outpatient center i.e. Clinic or Hospital.
  • Patient is asked to sleep on CT scan table so that doctor can get easy access to the injection site. A nurse helps patient to make him/her comfortable during and after the procedure.

Procedure of Epidural Injection Treatment

  • Doctor uses medicines as per the type of pain or disease. The different types of medications injected into the epidural space create different effects for patients.
  • Epidural Injection procedure takes around 15 to 45 minutes. The epidural injection usually takes only minutes to administer but positioning in the CT or x-ray unit takes more time.
  • Patient has to visit surgical clinic or hospital to undergo epidural injection procedure. Doctor or nurse asks patient to sit inside the CT scan room.
  • Doctor identifies the area to be injected, cleans and sterilizes the skin with an antiseptic solution.
  • A local anesthesia is given to the patient to numb the area before administering the epidural injection.
  • Once the area is numb, the doctor uses imaging guidance to help the epidural needle to get right position. When the needle is in perfect place, a contrast material is injected so the doctor can accurately target the nerves for sufficient distribution of the medication.
  • Finally, doctor slowly injects the medication which is typically a combination of anesthetic and anti-inflammatory drugs.
  • After the procedure, patient is kept under the supervision to check any side effects.

Result of Epidural Injections Treatment

The result of Epidural Injection treatment is mainly depending on the type and severity of pain. Many patients experience some pain relief after the procedure while some patients need more injections usually in 1 to 4 week intervals to achieve full effect. Result of epidural injection can last for weeks or years. Usually, epidural injection procedure is performed along with a physical therapy to strengthen the back muscles and to avoid recurrence of pain in future.