An epidural steroid injection, or ESI, is a non-surgical procedure used to ease back pain or numbness. The epidural space is in the spinal canal between the bones and nerves. Most commonly ESIs are used for patients with herniated discs, degenerative disc disease or spinal stenosis. All these conditions can cause painful swelling.

Steroids (coricosteroids) are potent and stop the pain-producing inflammatory chemicals. Once injected, patients may experience decreased pain for days or even years.

How to prepare for an epidural steroid injection
Because epidural steroid injections are specialized procedures, some preparation is needed before injection. Before your procedure, please do the following:

  • Eat and drink as normal, unless otherwise directed by your doctor.
  • Tell the technologist if you are or may be pregnant. An epidural steroid injection is generally not performed during pregnancy because of the potential risk of embryo/fetal injury.
  • Stop taking Coumadin (Warfarin), Plavix (Clopidogrel), Ticlid (Ticlopidine) and Pletal (Cilostazol) with permission from the prescribing physicians for 5 days before your epidural steroid injection. If you take Coumadin (Warfarin), a Prothrombin Time (PT) and INR will be obtained here at the clinic before the procedure.
  • Stop low-molecular weight heparin therapy with Lovenox (Enoxaparin), Fragmin (Dalteparin), Normiflo (Ardeparin) or Orgaran (Danaparoid) with permission from the prescribing physician for 24 hours before the injection.
  • Arrange for someone to drive you home after the procedure.
  • Bring a copy of the order for the procedure from your referring physician.

Download the epidural steroid injection preparation guide.

What to expect
Epidural steroid injections typically take 15-20 minutes. Before the injection, your skin will be cleansed with an antiseptic soap and numbed with local anesthetic. Then, the interventional radiologist guides the needle into the epidural space using x-ray imaging. Once the needle is in place, they will inject the steroid medication. After the injection, you will be observed for a short period before being discharged. You should rest at home for the rest of the day.

Most patients experience decreased pain in about a week. Your doctor may recommend a follow-up injection to prolong decreased pain symptoms. One of our board-certified interventional radiologists will review the images and send a report to your physician.


Dr. Steve Blount talks about epidural steroid injections. Learn more about what to expect during a steroid injection.

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