Epidural steroid injections (ESIs) are a common treatment option for many forms of lower back pain and leg pain. They have been used for decades and are considered an integral part of the nonsurgical management of sciatica and lower back pain.
The injection is named an epidural steroid injection because it involves injecting a local anesthetic and a steroid medication directly into the epidural space that surrounds the spinal cord and nerve roots.
The goals of an epidural steroid injection are to:
- Control pain by reducing inflammation in and around the nerve roots
- Improve mobility and function in the lower back and legs 1
- Allow the patient to participate in and make progress with a comprehensive physical therapy and rehabilitation program
In the course of one’s care program, in most cases, an epidural steroid injection may be recommended after a series of nonsurgical treatments, such as medications and physical therapy, 2 have been tried, and before surgery is considered.
The role of the injection is typically to provide sufficient pain relief to allow a return to everyday activities and to make progress in physical therapy.
Most practitioners will agree that an epidural injection can be beneficial during an acute episode of back and/or leg pain. The main drawbacks of the injections are that they are not always effective, and when effective, the pain relief tends to be temporary, ranging from one week to one year. Typically, if the initial injection is effective, up to 3 injections may be given in one year.
