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Epidural Steroid Injection

An epidural injection is the administration of medications into the epidural space. It is used to treat swelling, pain, and inflammation of the nerve roots, associated with herniated discs and radiculopathy (nerve irritation or injury). The medications used are steroid, which is anti-inflammatory, and numbing medications (local anesthetics).


The brain is covered by three membranes (dura, arachnoid, and pia), called the meninges that extend through the base of the skull and surround the entire spinal cord. The spinal cord travels down the entire length of the spinal column through the spinal canal. The epidural space is located between the dura and the interior surface of the spinal canal and contains veins, arteries, and fat. Epidural injection is the injection of medication into the epidural space.


Epidural injection is usually given in an outpatient setting. An anesthesiologist usually administers the injection, but some neurosurgeons, orthopedic surgeons, and neurologists are also qualified to perform this procedure.


A mild sedative and a local anesthetic may be given prior to the procedure to relax the patient and numb the injection site. Medications, usually an anesthetic such as bupivacaine (Marcaine), Lidocaine, and a corticosteroid such as Depomedrol, or celestone are injected directly into the epidural space. (The injection is commonly called a cortisone shot.)


After the treatment, some patients notice improvement within hours of the injection; others improve over a number of days; and others experience no improvement with the treatment. In some cases, two or three injections are given over weeks or months.


Complications that could result from an epidural injection are rare but can occur. Possible conditions that may develop following the procedure include infection (e.g., epidural abscess), bleeding into the epidural space, and headache caused by a cerebrospinal fluid leak.


Lumbar Epidural Steroid Injection for:

  1. Pain in the lower back

  2. Pain down one or both legs

  3. Numbness or tingling of your legs or feet

  4. Weakness in one or both legs or feet

Cervical Epidural Steroid Injection for:

  1. Pain in the neck or shoulders

  2. Pain down one or both arms

  3. Numbness or tingling of your shoulders, arms, or hands

  4. Weakness in one or both shoulders, arms, or hands


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