ESI FAQ:

What is an epidural steroid injection?

An epidural steroid injection places anti-inflammatory medication around an irritated spinal nerve to reduce pain that radiates into an arm or leg from a herniated disc, spinal stenosis, or nerve irritation. It's a non-surgical, outpatient procedure done under X-ray guidance, typically taking 15-30 minutes with no sedation required.

What types of ESI are there?

- Interlaminar - medication delivered broadly around the back of the epidural space; used when pain isn't limited to one specific nerve.

- Transforaminal - medication delivered precisely around one or two nerve root(s); used when imaging points to a specific level(s).

- Selective Nerve Root Block (SNRB) - a diagnostic version of the transforaminal approach, used to confirm which nerve is causing your symptoms.

What medication is used?

Most injections use a corticosteroid. We use a nonparticulate steroid (dexamethasone), which is safer if inadvertently placed near a blood vessel. Regenerative alternatives (such as platelet-rich plasma) may also be used as a steroid-sparing option for select patients.

What are the benefits?

- Reduced pain and inflammation

- Improved ability to participate in physical therapy

- May help you avoid or delay surgery

- Can help confirm which nerve is causing your symptoms

What are the risks?

Common and temporary: soreness, brief increase in pain, temporary numbness, or a mild headache.

Rare but serious: infection, bleeding, allergic reaction, nerve injury, or (very rarely) serious neurologic complications. These risks are minimized through X-ray guidance, contrast confirmation, and careful medication selection.

What are my alternatives to this procedure?

Physical therapy, oral medication, activity modification, observation, surgical referral, or declining treatment.

When should I call the office immediately?

Call right away if you experience fever, a severe or worsening headache, new weakness or numbness, or loss of bladder/bowel control.

Where can I learn more?

Visit our Services page for more on what to expect and how we tailor treatment to you: https://www.osso.health/services

Safety guidance adapted from the International Pain and Spine Intervention Society (IPSIS), 2025.