Did you know that ESI’s are both therapeutic and diagnostic? Epidural steroid injections (ESI’s) are a common treatment option for many forms of low back and leg pain as well as inflammation from pressure on the spinal cord. They have been used for low back problems since 1952 and are still an integral part of the non-surgical management of sciatica and low back pain.
This is how they work. An epidural steroid injection (ESI) is a combination of a corticosteroid with a local anesthetic pain relief medicine. Corticosteroids are strong anti-inflammatory medicines used to relieve pain. The local anesthetic medicine helps give you immediate pain relief. Corticosteroid medicines take longer to have an effect.
Diagnostic: The local anesthetic will numb the area (nerve) and all symptoms should drastically improve for a few hours. If they do not then you are not dealing with the true pain generator or you have a patient that may not be providing reliable subjective information.
Therapeutic effect: The anti-inflammatory effect of corticosteroids is unmatched to any other medication but it takes a little time. After the ESI is administered it takes the body 7 to 10 days to absorb and use the medication. This means you will see the benefits starting a few days after the injection and well into the second week afterward.
As you can see an ESI can provide relief and valuable information. The goal of the injection is pain relief; at times the injection alone is sufficient to provide relief, but commonly an ESI is used in combination with a comprehensive rehabilitation program to provide additional benefit and facilitate return to work.
  • References: spine-health.com and webmd.com