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Epidural Injection

Epidural Steroid Injection (ESI) provides relief caused by irritation of the spinal nerves. The procedure involves injecting local anaesthetic and anti-inflammatory medicine to the epidural space under imaging guidance for precise injections.

The protective covering surrounding the spinal cord is called the dural sac. It ends at the vertebral level of the second vertebrae and contains fluids that provide nourishment for the spinal cord. Nerves that extend from the spinal cord pass through the epidural space.

The ESI procedure can be performed in the neck (cervical), middle back (thoracic) or lower back (lumbar). This helps to provide relief depending on where the patient feels pain.

Prior to the procedure

The injection provides pain relief. Before undergoing the procedure, patients are required to find a driver to take them to clinic and back home. Patients who are diabetic should discuss medication with their doctor and provide details on any prescriptions or supplements being taken.

You may be asked to stop taking certain medications (e.g. Warfarin, Aspirin or Plavix) several days prior to the injection. It is important that you tell your doctor immediately if you have previously had any allergic reactions to injected contrast (CT, angiogram, etc.).

During the procedure

One of our interventional radiologists will be performing the procedure in our CT room. An antiseptic solution will be used to clean your skin and your radiologist will then inject local anaesthetic to numb the affected area before the ESI procedure.

Once the anaesthetic starts to take effect, another needle is inserted under the aid of a CT scanner to confirm the position. A mixture of long acting anaesthetic and anti-inflammatory medicine is then injected into the region. The procedure takes approximately 10 to 15 minutes.

After the procedure

Patients may experience weakness or numbness in the legs (lumbar injection), arms (cervical injection) or chest wall (thoracic injection) for several hours following the procedure. Please inform your radiologist if you are experiencing any discomfort.

Patients are strongly advised to refrain from any physical activity that requires lifting. Please arrange your own transportation and do not operate a motor vehicle for the rest of the day. You will be able to return to normal activity and work the next day.

In some cases, we may recommend physical therapy as part of an interventional pain management plan. It is essential that you adhere to physical therapy if your radiologist prescribes it.

You may feel immediate relief following the injection due to the numbing medicine but there is a possibility the pain may return within a few hours. Let your radiologist know immediately if this is the case. The cortisone medication can take between 2 to 3 weeks to start working.


Painsense offers a comprehensive range of interventional pain management services to exceptional standards in our professional clinic. Bookings are required for ESI procedures. Call us today and we will fit you in the next available time that is convenient for you.