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Epidural steroid injections – caudal, intralaminar or transforaminal

Temporary Relief for Sciatica and Lower Back Pain

Epidural steroid injections target the ‘sleeve’ surrounding the spinal cord to  reduce swelling around the nerves and provide pain temporary relief. Often, that break in pain and swelling allows the body’s natural healing processes to start. Effects can last for several months, and ESI can be repeated periodically at the physician’s recommendation. The procedure is often used for temporary pain relief due to:

The three methods of delivering steroid injections into the epidural space -- caudal, intralaminar and transforaminal -- all involve the use of X-ray guidance technology to insert a small needle into the desired location. All can be performed in an office setting and require little or no recovery time. Results can felt in one to three days.

Caudal epidural steroid injections target the very bottom of the epidural space just above the tailbone. Injection of a steroid at this location allows it to spread widely and to all sides of the epidural sac. The same is true for Intralaminar injections which are useful in treating wide areas of the spine.

Transforaminal ESI delivers the steroid near the nerve where it exits the spine. The medication travels up the nerve sleeve and into the epidural space. This method allows the physician to target a specific area with a concentrated amount of medication, even to the level of single nerves. The procedure is also useful in diagnosing specific pain centers.

Your Columbia Pain & Spine Institute physician can determine which procedure is recommended for your condition.