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Epidural Steroid Injection (ESI) is a non-surgical method to treat inflammation of nerves in the spine, and thereby reduce spine pain. The injection is usually used to treat conditions of spinal stenosis, disc herniation, degenerative disc disease, recurrent pain following spine surgery, etc. Epidural injections can also flush out inflammatory proteins, and treat pain related to shingles and slippage of the vertebral column.
Steroids hinder the inflammation, and reduce the activity of the immune system. In order to protect it against foreign substances such as bacteria, viruses, and infection, our body generates White Blood Cells and chemicals, and this causes inflammation. Steroid injections inhibit this immune response, and thus reduce pain.
With this method of treatment, steroid medication, similar to cortisone, is injected into the epidural space of the spine, which is the location of inflamed nerves. However, an epidural injection should not be performed for pain due to infections or tumors as this can be checked by MRI scans.
The most common method for epidural injections is by X- Ray Guidance (fluoroscopy). With this procedure, a local anesthetic is applied and then the steroid is injected into the epidural space in the spine through a needle. Commonly used steroids are Dexamethasone, Triamcinolone, Acetonide, and Methylprednisolone acetate. Lidocaine is a local anesthetic that can also act as flushing agents; however, it does not completely sedate the patients.
The number of injections needed vary depending on the intensity of the pain. Typically, patients experience relief from pain after the first injection, although, in some complex cases, a series of 3 injections are prescribed at an interval of two weeks.
The whole procedure takes about 5-10 minutes, and thus, it is a safe, simple, and effective method for spine pain management. After the injection, a full days rest is necessary and driving should be avoided for 8 hours.
You should not eat any food or drink 8 hours before the injection, and if you are taking any kind of medication, then you should discuss it with your doctor. In most cases, there will not be any side effects, but rarely there can be bleeding, infection, headache, allergic reactions, and other mild steroid side effects.
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