Epidural Steroid Injections

There are four different epidural steroid injections the Helm Center offer’s patients looking for relief from low back pain:

  • Cervical Epidural Steroid Injection
  • Caudal Steroid Injection
  • Lumbar Epidural Steroid Injection
  • Lumbar Transforaminal Epidural Steroid Injection

Transforaminal Epidural Steroid Injection

Transforaminal Epidural Steroid Injection:

Drawing of a disc herniation compressing the nerve root.

Epidural steroid injections are the most common procedure we do. The underlying idea is that by bathing an inflamed nerve root in steroids, which are anti-inflammatories, we can decrease the irritation of the nerve root that is causing pain. They are most commonly used in situations of radicular pain, which is pain that goes down the leg.

The nerve root is most often irritated by an inflamed disc touching the nerve or by chemicals that normally occur in the disc leaking out and irritating the disc:

The procedure is quick and simple. While most people are concerned prior to the procedure, the most common response we have afterwards is, “Is that all?”

The epidural steroid injection procedure is very simple. The spinal cord goes through the spinal canal, giving off nerve roots as it goes. The cord is protected by Cerebral Spinal Fluid (CSF), which serves as a shock absorber for the cord. The CSF is held in place by a membrane with several layers, one of which is called the Dura, from the Greek for tough (think of “durable”) The Greek word “epi” means outside of, so the epidural space is outside of this tough membrane. We can enter the epidural space and deposit small amounts of long-lasting steroids, so that we have specifically targeted the inflamed area and treated it with maximal amounts of steroids, while avoiding exposing the rest of the body to the steroids.