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When is an Epidural Steroid Injection the Best Choice for Managing Your Back Pain

Here at the Premier Spine Institute, Bonaventure Ngu, MD, specializes in helping people manage and even eliminate their back

Back pain is tricky business. It can stem from a variety of causes and result in an array of symptoms. Sometimes your back’s just achy from overuse, and a gentle massage or a warm bath can relieve your pain. But if your back has been bothering you for more than six weeks, or if you’re pain is so extreme it’s debilitating, it’s time to seek professional help.

Here at the Premier Spine Institute, Bonaventure Ngu, MD, specializes in helping people manage and even eliminate their back pain through a series of conservative, noninvasive, minimally invasive, and surgical treatments, including epidural steroid injections. 

What is an epidural steroid injection?

The word “epidural” simply means the space around your spine. The steroid is cortisone, an anti-inflammatory agent, and it’s usually mixed with an anesthetic.

Dr. Ngu injects the medication into the epidural area, the fat-filled column that surrounds your fluid-filled spinal sac and protects your spinal nerves. The anesthetic has an immediate numbing effect that brings you quick relief, but the steroid won’t kick in for a few days. 

The main function of the epidural steroid injection is to reduce the swelling that’s responsible for your back pain. 

Do epidural steroid injections relieve all types of back pain?

Your back pain may be the result of:

The source of your pain matters, as epidural steroid injections are not effective for all types of back pain.

You’re a good candidate for epidural steroid injections if you have bone spurs, spinal stenosis, a herniated disc, thickened spinal ligaments, or sciatica. General back pain due to sore muscles, spasms, etc., is not a reason to opt for ESI, which targets inflamed nerves rather than large muscle groups. 

How long does the pain relief from an epidural steroid injection last?

ESI is intended to reduce pain and swelling long enough to allow healing to take place. It is not a cure, but rather an assistive measure that makes it possible for you to pursue other treatments such as physical therapy and rest. It may also allow you to postpone surgery, if need be. 

Most patients who have an epidural steroid injection report up to three months of pain relief, but results vary depending on multiple factors. 

How does an epidural steroid injection compare to other treatments?

Dr. Ngu always begins with the most conservative approach to your pain. There is no reason to jump straight to ESI when you have back pain.

NSAIDs and rest

Nonsteroidal anti-inflammatory drugs (NSAIDs) like ibuprofen are the most common initial treatments for your back pain. Rest is another important, yet often overlooked, part of the treatment and healing process. Often, that is all you need to get past the worst of the pain.

Physical therapy

NSAIDs and rest can take the edge off your pain so you can engage in physical therapy that strengthens the support system in and around your back. 

When supervised by a trained professional, exercise can re-establish a strong musculoskeletal system that properly supports your spine and corrects problems that may be causing you pain, such as alignment issues. Physical therapy can go a long way in increasing your flexibility and range of motion.


Epidural steroid injections are the second phase of back pain relief. Dr. Ngu may recommend ESI only after you’ve tried other, more basic treatments first and have shown no improvement. ESI is a safe and effective option that can help you focus on healing your underlying condition. It does have a few potential side effects, such as complications at the site of the injection, or a headache after the procedure, but they are minor and rare.


In more extreme cases, surgery may be necessary to remove damaged tissue or repair your discs and vertebrae. Even then, Dr. Ngu opts for less-exposure surgical techniques that cause less trauma, pain, and recovery time.

If your lower back pain is persistent and not responding to rest and over-the-counter pain relievers, call us or request an appointment online to find out if ESI is right for you.

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