Epidural Steroid Injections eMedicine PMR

Description: Epidural steroid injections (ESIs) have been endorsed by the North American Spine Society and the Agency for Healthcare Research and Quality (formerly, the Agency for Health Care Policy and Research) of the Department of Health and Human Services as an integral part of nonsurgical management of radicular pain from lumbar spine disorders. Radicular pain is described as a sharp, lancinating, radiating pain, often shooting from the low back down into the lower extremity in a radicular distribution. Radicular pain is the result of a nerve root lesion or of inflammation. Clinical manifestations of nerve root inflammation include some or all of the following: radicular pain, dermatomal hypesthesia, weakness of muscle groups innervated by the involved nerve roots, diminished deep tendon reflexes, and positive straight leg–raising tests. ESIs have been recommended to deliver steroids in a more localized fashion to the area ofaffected nerve roots, thereby decreasing the systemic effect of the administered steroids. Studies have indicated that ESIs are most effective in the presence of acute nerve root inflammation.
Synonyms and related keywords: epidural corticosteroid injections, ESIs, nonsurgical management of radicular pain, nerve root inflammation
Chen et al 2007 Updated: Feb 18, 2009