Epidural Steroid Injection (ESI)
Epidural Steroid Injections are minimally invasive procedures designed to relieve pain caused by nerve inflammation in the spine. These injections deliver anti-inflammatory medication directly to the source of pain, helping patients with conditions such as herniated discs, sciatica, and spinal stenosis.
What does an ESI treat?
Herniated Disc
Sciatica
Spinal Stenosis
Degenerative Disc Disease
Procedure Steps
Preparation: Local anesthetic numbs the area.
Needle Guidance: X-ray guides the needle to the nerve.
Injection: Contrast dye confirms placement, followed by steroid injection.
Recovery: Most patients resume normal activities within 24 hours
Benefits of ESI
Targeted Pain Relief: Directly addresses the inflamed nerve.
Minimally Invasive: No surgery needed.
Quick Recovery: Return to routine activities within a day.
Preparation & Post-Care
Before: Stop certain medications as directed by your provider, fast for 3 hours, and arrange a driver if sedated.
After: Avoid vigorous activities and submerging the injection site for 24 hours. Relief is commonly reported within 7 days.
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Interlaminar epidural steroid injections (IESI) treat a broader area, while transforaminal epidural steroid injections (TFESI) target specific nerve roots.
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The injection itself takes about 15-30 minutes.
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Discontinue the following medications:
Lovenox (enoxaparin) 12-24 hours prior to procedure
Integrilin (eptifibatide) 1 day prior to procedure
Aggrastat (tirofiban) 1 day prior to procedure
Pletal (cilostazol) 2 days prior to procedure
Trental (pentoxifylline) 2 days prior to procedure
Eliquis (apixaban) 3 days prior to procedure
Savaysa (edoxaban) 3 days prior to procedure
Xarelto (rivaroxaban) 3 days prior to procedure
Pradaxa (dabigatran) 3 days prior to procedure
Arixtra (fondaparinux) 4 days prior to procedure
Aspirin 5 days prior to procedure
Warfarin (coumadin) 5 days prior to procedure
Reopro (abciximab) 5 days prior to procedure
Brilinta (ticagrelor) 5 days prior to procedure
Aggrenox (dipyridamole) 7 days prior to procedure
Plavix (clopidogrel) 7 days prior to procedure
Effient (prasugrel) 7 days prior to procedure
Ticlid (ticlopidine) 14 days prior to procedure
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What should I do before the procedure?
Medication: Stop blood thinners and specific medications as directed by your provider.
Fasting: Avoid eating for 3 hours before the procedure; clear liquids are allowed up to 1 hour before.
Allergies: Inform your doctor if you’re allergic to latex, adhesives, anesthetics, steroids, or contrast dye.
Arrange Transport: If sedation is used, plan for someone to drive you home.
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Avoid submerging the injection site in water for 24 hours and limit vigorous activities.
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Conscious sedation is offered at a self pay rate of $250 to help you feel more relaxed. Undergoing conscious sedation will require that you have a driver.