Epidural Steroid Injection (esi) in Bangalore

Epidural Steroid Injection (ESI) is a minimally invasive spine pain injection used to reduce inflammation and relieve pain caused by irritated spinal nerves.

The injection is given in the epidural space (the area around the spinal cord and nerve roots).

Usually, two medications are injected:

Local Anesthetic

Purpose:

Gives immediate pain relief

Confirms correct nerve level

Improves patient comfort during procedure

Corticosteroid

Purpose:

Reduces inflammation around compressed nerve roots

Controls swelling

Provides long-term pain relief

The anesthesia works immediately, while the steroid starts working within 24–72 hours.

Why Both Are Used?

Immediate pain relief (local anesthetic)

Long-term inflammation control (steroid)

Diagnostic + therapeutic benefit

Lumbar Epidural Injection – for lower back and leg pain

Cervical Epidural Injection – for neck and arm pain

Caudal Epidural Injection – given from tailbone area

Transforaminal Epidural Injection – targeted nerve root injection

An epidural injection works by reducing inflammation around irritated spinal nerve roots, which are usually compressed by a disc bulge, herniation, or spinal stenosis.

Exact Procedure (Step-by-Step)

Patient lies prone or sideways

Skin is cleaned and sterilized

Local anesthesia given to numb skin

Needle inserted under fluoroscopy (X-ray guidance)

Contrast dye used to confirm correct position

Steroid + anesthetic injected

Needle removed and small dressing applied

Procedure time: 15–30 minutes

Observation time: 30–60 minutes

Same-day discharge

During procedure:

Mild pressure sensation

Temporary tingling in leg/arm (normal)

After procedure:

Immediate relief due to anesthetic

Mild soreness at injection site

Steroid effect begins in 1–3 days

The number of epidural steroid injections required depends on the severity of nerve inflammation and the patient’s response to the first injection.

Usually 1 injection initially

Maximum 3 injections per year (depending on condition)

Often spaced 2–4 weeks apart

(Depends on severity & response)

Yes, when performed under image guidance by a trained pain specialist.

Possible minor side effects:

Temporary increase in pain

Headache

Facial flushing

Temporary rise in blood sugar

Serious complications are rare.

The effects of epidural steroid injection are as follows:

Faster inflammation control

Reduced nerve irritation

Relief in radiating pain (sciatica)

Improved mobility

Better participation in physiotherapy

May delay or avoid surgery

Here are the contraindications for Epidural Steroid Injection:

Active local or systemic infection

Uncontrolled bleeding disorder

Patient on anticoagulants (without proper stoppage protocol)

Allergy to steroid, local anesthetic, or contrast dye

Lack of patient consent

Relative Contraindications (Use Caution)

Uncontrolled diabetes (steroids raise blood sugar)

Severe spinal deformity

Pregnancy

Severe spinal canal compromise

Uncontrolled hypertension

Immunocompromised patients

After pain relief, physiotherapy is essential as it helps:

Strengthen core muscles

Improve spinal stability

Correct posture

Prevent recurrence

Restore functional movement

Long-term results

Reduced dependency on repeated injections.