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Interlaminar Epidural Steroid Injection (ESI)

Treating Pain in Residents of North Central Arkansas & South Central Missouri

Epidural Steroid Injections (ESI) are fairly painless procedures that utilize tiny needles. They are usually used to treat acute and chronic pain conditions in patients. ESIs are generally utilized to help lessen inflammation and irritation around specific groups of nerves in the neck area, mid-back area, and lower back area. These nerves can produce radicular pain when they are irritated. Radicular pain is a specific type of pain that travels along the nerve and you can feel it in your limbs, around your chest, and in your hips. This type of pain is usually described as an aching, burning, tingling, or shooting, numbness or electricity.

Several medical conditions commonly treated by way of ESI are:

  • Stenosis: Spinal canal or nerve root exits are narrowed
  • Failed back surgery syndrome: Pain that is felt even after a spinal surgery
  • Degenerative disk disease
  • Bulging or herniated disks
  • Radiculopathy: Pain that moves down your arms or legs
  • Sciatica

For more information regarding this procedure, please call Interventional Pain Management, a department of Baxter Regional, at (870) 508-5900.

The Procedure

On the day of your procedure, please arrive at least 20 minutes prior to the scheduled appointment. Our skilled nurses will begin an IV if you want to be sedated and we will conduct a pre-operation nurse assessment. You will then be directed to the procedure room and will lie down on a hospital bed. Once we have you situated in the operating room, you will be sedated and given nitrous oxide gas to induce comfort. We will place a cold cleaning solution on your skin in order to lower your chance of infection. Then, using x-ray guidance, our doctors will identify the site for the procedure. Once we identify the procedure site, we will apply a shot of anesthetic to numb the area. It may sting slightly, but the pain will pass in a couple seconds. Using x-ray guidance, the spinal needle will then be placed into position. Next, we will inject dye in order to confirm the correct needle placement and to observe the medicine spreading in the celiac plexus. Steroids and anesthetics will comprise the medication that we inject through the needle. The medication will disperse in your celiac plexus and cover the cluster of nerves. Then, we will repeat the procedure on the opposite side to make sure the entire celiac plexus has been medicated. Many patients report that they feel relief fairly quickly. We will then take the needle out and take you to a separate room for recovery. The entire procedure only takes about 10-15 minutes and afterwards, we will observe you for 15 more minutes to ensure the effects are working properly. You are then free to travel home and recover comfortably.

What You Should Expect Afterwards

The medication’s effects usually start working in three to five days, but it can sometimes take up to a week to feel the full benefits. Most of the time patients report feeling relief from their radicular pain first. This is common and expected. Many patients say they feel less pain and are able to engage in more physical activities as a result. The medication usually has limited side effects, but some patients may experience anxiety, trouble falling asleep, temporary water retention, or changes in their menstrual cycles. If you are diabetic, you may experience elevated blood sugar levels for a couple days. Fortunately, these side effects are generally very mild and will often clear up within several days.

ESIs have been perfected over the past several decades and are typically considered a safe and effective way to treat acute and chronic pain conditions. Medical complications are rare but they could include allergic reactions, bleeding, infections, headaches, paralysis, and damage of the nerves. Although not all patients experience total pain relief with ESIs, the injections frequently reduce the level of pain and allow for improved functionality. Your initial round of epidural injections can be completed in a set of three injections three weeks apart. If you feel that the ESIs are significantly helping reduce your pain and inflammation, you can have repeated and periodic injections to maintain the pain improvements. ESIs are usually used in conjunction with other treatments in order to try and maximize the procedure’s medical benefits.

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