ESI is a procedure that places a small amount of powerful anti-inflammatory medication, cortisone, around inflamed spinal nerves in the epidural space. It reduces the swelling, irritation, and pain caused by the pinched nerves.
ESI and labor epidural are similar but different. Labor epidural uses anesthetics while ESI uses cortisone. ESI is performed with a smaller needle with the patient lying flat on the abdomen. A moving x-ray machine (C-arm) is usually used to precisely place the needle.
With local anesthesia, most patients find ESI easily tolerated. A sedative is rarely needed but available.
ESI is performed as a series of 2 to 3 injections over several weeks. The series can be repeated later, if the problem requires.
Cortisone is neither a pain medication nor an anesthetic. It is an anti-inflammatory medication. It is a compound similar to what the body normally produces, especially at times of stress. Cortisone helps the body recover. One’s faculty and sensations will remain intact, thus one will not injure oneself unknowingly.
Problems with ESI are rare. Cortisone is a steroid, but is not a performance-enhancing anabolic steroid. Steroid is more likely to cause problem when it is used long term, such as for treating rheumatoid arthritis or asthma. A short series of ESIs is unlikely to cause steroid-related problems.
ESI can be used to treat nerves along the entire spine. Lower back and neck are the most common locations for the procedure.
Precise medication delivery to the injured area is essential for good response. X-ray guidance is the standard.