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Epidural steroid injections

Updated: May 14, 2022




It is the most commonly utilized intervention for managing chronic and acute lower back pain


These injections may benefit patients with radiculopathy, degenerative disc disease, disc herniation, refractory discogenic pain, spinal nerve compression, spinal nerve root irritation or inflammation, foraminal or central canal stenosis, vertebral compression fractures, herpes zoster/postherpetic neuralgia, post laminectomy syndrome, complex regional pain syndrome, peripheral neuropathy, phantom limb, or cancer-related pain. Additionally, thoracic epidural steroid injections may benefit patients with angina, pancreatic disease, and incisional neuralgia after thoracotomy or breast surgery. Caudal epidurals may benefit patients with sacral or coccygeal neuralgia, interstitial neuritis, as well as pelvic, rectal, perineal, penile, or testicular pain.


Absolute contraindications:

Haemodynamic instability, patient refusal, local malignancy, local infection, uncorrected haemoglobinopathy, acute spinal cord compression, increased intracranial pressure, anaphylaxis, and inability for patient to stay still


Relative contraindications:

Systemic infection, allergy to medications or contrast, immunosuppression, pregnancy, or difficult anatomy


complication: Epidural lipomatosis is a rare but possible complication of repeated epidural steroids.



Videos:


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Evidence:


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