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What are epidural steroid injections?

An epidural steroid injection (ESI) is a minimally invasive pain management procedure in which local anaesthesia and corticosteroids are injected into the epidural space around the spinal cord and nerve roots. By delivering medication directly into this space, epidural steroid injections aim to reduce inflammation and alleviate pain originating from spinal nerve roots.

There are several types of epidural steroid injections available, depending on where the injection point is located, such as:

  • Cervical epidural steroid injection: cervical epidural steroid injections are administered into the epidural space around the neck/cervical. It is used to treat cervical radiculopathy, which refers to pain that radiates down from your neck and then to your shoulders, arms, and hands.
  • Thoracic: thoracic epidural steroid injections are administered to the thoracic region or middle part of the back. They are used to alleviate pain in the spine’s upper or middle region.

Caudal: caudal injections are administered to the tailbone region of the spine and are used to treat chronic lower back and chronic leg pain.

epidural steroid injection Singapore
An epidural steroid injection is a combination of local anaesthetic with steroid or corticosteroid that is used to treat chronic pain.

How do epidural steroid injections work?

Epidural steroid injections are typically used for chronic pain management by injecting a combination of steroids or corticosteroids and a local anaesthetic into the epidural space around the spinal cord. The steroid or corticosteroid medication is often a synthetic version of a hormone naturally produced in your body, known as cortisol. 

Cortisol is a potent anti-inflammatory agent that reduces the inflammation around the spinal nerves when injected into the epidural space. This helps to relieve the pressure on the nerves and decrease pain, among other symptoms.

The local anaesthetic component temporarily numbs the affected nerves, providing immediate pain relief while the corticosteroid takes effect.

Benefits of epidural steroid injections

  • Improved quality of life
  • Minimally invasive 
  • Targeted treatment
  • Reduces inflammation and nerve pain
  • Effective pain relief
  • Improved mobility and functionality

What conditions can epidural steroid injections treat?

In Singapore, epidural steroid injections are used to treat various spinal conditions, including:

How are epidural steroid injections administered?

Epidural steroid injections are typically administered in the following ways:

  • The patient is positioned on an examination table, lying on their stomach or side to expose the back. The area to be injected is cleaned and sterilised to reduce the risk of infection.
  • Local anaesthesia is administered to reduce any pain or discomfort related to the procedure.
  • Once the anaesthesia has taken effect, the epidural needle is guided into the treatment area using fluoroscopy or ultrasound guidance for accuracy. 
  • After numbing the area, your doctor will insert the epidural needle by using an imaging machine as guidance.
  • Once the epidural needle is in the epidural space, a combination of medications is administered. This typically includes anaesthesia and corticosteroids. 
  • After the medication has been administered, fluoroscopy or ultrasound will be used again to confirm the accurate placement of the medication within the epidural space. The patient will also be monitored for any adverse reactions or side effects.
  • The injection site will be cleaned again, and a dressing will be applied. 
  • Post-procedural care includes avoiding strenuous activities for a brief period, applying ice to the injection site to reduce swelling, and monitoring for any signs of infection or adverse reactions.
epidural steroid injections Singapore
After administering local anaesthesia to numb the injection site, your doctor will slowly insert an epidural needle to proceed with the pain management treatment.

How many sessions of epidural steroid injections are needed?

The number of epidural steroid injection sessions required varies depending on the specific condition being treated, its severity, and individual response to treatment. For most individuals, epidural steroid injections will be recommended three to six times a year, spaced several weeks apart. However, some patients may experience significant pain relief after just one injection, while others may require additional sessions.

Frequently Asked Questions

The effects of epidural steroid injections can typically last up to a few months. However, the duration of pain relief provided by epidural steroid injections (ESIs) can vary widely depending on several factors, including the underlying condition being treated, the severity of symptoms, and the individual patient’s response to treatment. However, it’s essential to recognise that the effects of ESIs are often temporary, and the duration of pain relief may diminish over time.

Before the epidural steroid injection is administered, the area is numbed with local anaesthesia, which may cause a mild stinging sensation. However, the rest of the procedure is typically painless once the anaesthesia takes effect.

After the day surgery procedure, you will be observed for up to 30-60 minutes. If you experience no adverse side effects, you can go home and resume your normal activities.