Procedure Description
Epidural steroid injections (ESIs) are minimally invasive procedures used to deliver anti-inflammatory medication (steroid) and a local anesthetic into the epidural space around the spinal cord and nerves. This reduces inflammation and irritation of the spinal nerves, providing relief from pain that radiates into the arms or legs.
There are two main types of epidural steroid injections:
Transforaminal ESI: Targets a specific nerve root by injecting medication into the foramen (the opening where nerves exit the spine). It is highly targeted and often used when one particular nerve is affected.
Interlaminar ESI: Involves placing the needle between the laminae (bones at the back of the spine) to deliver medication into the central epidural space. This approach is more general and used when pain is diffuse or involves multiple levels.
Both techniques are performed under fluoroscopy (X-ray) guidance for accuracy and safety.
What It Treats
Transforaminal and interlaminar epidural steroid injections are used to treat:
Herniated or bulging discs
Spinal stenosis
Sciatica or lumbar radiculopathy
Cervical or thoracic radiculopathy
Degenerative disc disease
Post-surgical spinal pain (Failed Back Surgery Syndrome)
These injections are especially effective for nerve-related pain that radiates into the arms (cervical) or legs (lumbar), often described as burning, shooting, or electric-like.
How It Is Performed
You will lie on your stomach (for lumbar/thoracic) or side (for cervical).
The skin is cleansed, sterilized, and numbed with a local anesthetic.
Using fluoroscopy (X-ray guidance), a thin needle is advanced into the epidural space:
Transforaminal approach: Needle is placed near the affected nerve root as it exits the spine.
Interlaminar approach: Needle is inserted between the vertebral laminae into the central epidural space.
A contrast dye is injected to confirm accurate placement.
A mixture of steroid and local anesthetic is injected.
The needle is removed, and a small bandage is applied.
The procedure typically takes 15–30 minutes and is performed in an outpatient setting.
Pre-Procedure Instructions
Do not eat or drink for at least 6 hours if sedation is planned.
Take your routine medications unless instructed otherwise. Blood thinners may need to be paused—consult your provider.
Inform your provider if you:
Are allergic to steroids, local anesthetics, or contrast dye
Are pregnant or breastfeeding
Have an active infection or fever
Arrange for a driver if you are receiving sedation or feel discomfort afterward.
Wear loose, comfortable clothing to your appointment.
What to Expect After the Procedure
You may experience temporary numbness or weakness in the affected arm or leg, which usually resolves within a few hours.
Pain relief can begin within 1–5 days, but steroid effects may take up to a week to peak.
Relief may last weeks to several months, depending on your condition and response.
You may resume light activity the same day and return to normal activity within 24–48 hours, unless otherwise advised.
A series of injections (up to 3) may be recommended for optimal relief.
Call your provider if you experience:
Severe pain, new numbness or weakness
Fever or chills
Signs of infection at the injection site
Precise, Non-Surgical Relief for Spine and Nerve Pain
At Parkview Spine & Pain, we specialize in fluoroscopically guided transforaminal and interlaminar epidural steroid injections to provide long-lasting relief for patients with radicular spine pain. These treatments help you avoid or delay surgery and get back to living with less pain.
👉 Schedule your consultation today to find out if epidural steroid injections are right for your condition.