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Epidural Steroid Injections

Epidural steroid injections (ESIs) are a common treatment option for many forms of low back pain and leg pain. 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. The goal of the injection is pain relief; at times the injection alone is sufficient to provide relief, but commonly an epidural steroid injection is used in combination with a comprehensive rehabilitation program to provide additional benefit.

Most practitioners will agree that, while the effects of the injection tend to be temporary — providing relief from pain for one week up to one year — an epidural can be very beneficial for a patient during an acute episode of back and/or leg pain. Importantly, an injection can provide sufficient pain relief to allow a patient to progress with a rehabilitative stretching and exercise program. If the initial injection is effective for a patient, he or she may have up to three in a one-year period. In addition to the low back (the lumbar region), epidural steroid injections are used to ease pain experienced in the neck (cervical) region and in the mid-spine (thoracic) region.

Although many studies document the short-term benefits of epidural steroid injections, the data on long-term effectiveness are less convincing. Indeed, the effectiveness of lumbar epidural steroid injections continues to be a topic of debate. This is accentuated by the lack of properly performed studies.

Epidural steroid injections deliver medication directly (or very near) to the source of pain generation. In contrast, oral steroids and painkillers have a dispersed, less-focused impact and may have unacceptable side effects. Additionally, since the vast majority of pain stems from chemical inflammation, an epidural steroid injection can help control local inflammation while also “flushing out” inflammatory proteins and chemicals from the local area that may contribute to and exacerbate pain.

While the effects of an epidural steroid injection tend to be temporary (lasting from a week to up to a year) an epidural steroid injection can deliver substantial benefits for many patients experiencing low back pain.

  • When proper placement is made using fluoroscopic guidance and radiographic confirmation through the use of contrast, > 50% of patients receive some pain relief as a result of lumbar epidural steroid injections.
  • Pain relief is more often felt for primary radicular (leg) pain and, less prominently, low back pain.
  • The pain relief and control brought on by injections can improve a patient’s mental health and quality of life, minimize the need for painkiller use, and potentially delay or avoid surgery.


At the Edward A Smith Law Offices, we understand your pain. We have counseled numerous acute and chronic pain patients who have suffered injury from a motor vehicle accident and or other types of personal injury. We have empathy, compassion, and understanding of your pain. In addition to practicing law and handling your case with the utmost in experience and expertise, we have a referral network with a team of professionals including doctors, chiropractors, surgeons, and physical therapists to better treat your needs holistically.

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