An Epidural Steroid Injection is an injection of a very small dose of a long lasting steroid ("cortisone") in the Epidural space – the area which surrounds the spinal cord and the nerves coming out of it. The dose is so small because we are able to apply the steroid directly to the inflamed/injured section of the back, rather than having the patient take a large dose by mouth for several days.

The actual epidural steroid injection takes only a few minutes. There are several ways to perform the injection-
interlaminar, which is the manner in which epidurals for pregnancy are performed, from the back of the spine
transforaminal, which is done using a small needle though the side of the spine where the irritated nerve exits
caudal- which is through the bottom of the spinal column above your tailbone.

Most often we perform transforaminal injections because they place the medication in the anterior epidural space where the irritation is usually located and because the needles are the smallest (25 or 27 gauge- the same as acupuncture). The epidural steroid injection consists of a mixture of local anesthetic (like lidocaine or bupivacaine) and the steroid medication, most often triamcinolone – Kenalog® or methylprednisolone – Depo-medrol®. The steroid injected reduces the inflammation and/or swelling of nerves in the Epidural space. This will reduce pain, tingling & numbness and other symptoms caused by nerve inflammation / irritation or swelling.

The immediate pain relieving effect of the epidural steroid injection is usually from the local anesthetic injected. This wears off in a few hours. Then, cortisone starts working in about 2-3 days and its effect can last for several days to a few months of being pain free.

You may resume your normal activities immediately following the procedure. You may drive yourself home, although some patients are more comfortable allowing someone else to do so. You may experience some very minor soreness at the epidural steroid injection site for the first 24 hours after receiving your epidural steroid injection. If so, applying ice will help reduce your discomfort or pain medications may be prescribed for you.

If you are interested in epidural steroid injection to manage or treat your pain, the pain management doctors of Park West Pain Management of Manhattan, New York and Staten Island, New York would be happy to see you for a consultation and help you learn about the treatment options available to you.