Epidural Steroid Injections (ESI)

What is an ESI?

An epidural steroid injection is a pain management option for people with low back, leg, arm, and neck pain. The injection involves a minimally invasive procedure where a steroid, combined with a numbing agent, is administered into the epidural space of the spine. Depending on the patient’s area of pain, the injection is positioned at a specific level of the spine and side of the body to directly target the affected nerve roots. The injection works to decrease inflammation and pain, as to hopefully improve function for the patient. Most individuals begin to feel relief after only a few days that may last anywhere from a few weeks to several years after the procedure.

Who qualifies to get an ESI?

Epidural steroid injections are helpful to people who have painful inflammatory conditions. Some of these conditions may include; Sciatica, Degenerative Disc Disease, Herniated Disc, and Spinal Stenosis. The injection is an interventional method that can be used to determine whether surgery may or may not be necessary for one of these conditions. Often times the relief provided by an ESI gives patients the ability to work on improving their condition through resources such as physical therapy that may have been too painful before.

Patients considering an ESI should consult with their doctor prior, to ensure this is a safe option for them. The injection can cause a spike in blood-sugar levels for those with diabetes and individuals taking blood-thinners will be asked to stop taking this medication a few days before the procedure.

What to expect from the procedure:

The ESI is an outpatient procedure that can be performed in 15-45 minutes. The patient is awake during this time in order to provide feedback to the physician, although they may be provided mild sedation and a local anesthetic. If any sedation is used, the patient should bring a driver with them the day of the procedure.

The next day normal activity may be resumed but individuals should expect a little soreness and swelling around the injection site. A follow-up appointment will need to be scheduled to discuss with the doctor the effectiveness of the injection and any other concerns you may have.



What is a Pain Specialist?

It seems like there are specialists for everything these days. With over 100 million people living with chronic pain (in the United States alone) it is only fitting that there should be specific doctors for this epidemic.

The term “pain specialist” can encapsulate multiple types of techniques and treatment methods but all these doctors have the same goal of managing pain for their patients. Many of these doctors have training in anesthesiology, physical therapy, or even neurology and treat conditions ranging from headaches, to recent injuries, to chronic illness. These specialists are often referred by your primary care doctor and work in tandem to treat underlying problems.

Some common issues that are treated by pain specialists include: back pain, neck pain, knee pain, Arthritis, neuropathic pain, headaches, Complex Regional Pain Syndrome (CRPS), pelvic pain, Fibromyalgia, autoimmune diseases, herniated disc, Degenerative Disc Disease (DDD), Sciatica, Scoliosis, wrist pain and Carpal Tunnel, Postherpetic Neuralgia (pain after shingles), Diabetic Polyneuropathy, phantom limb pain, spine and spinal cord disorders.

There are a variety of treatment options for dealing with this pain and a specialist makes this decision based on an individual basis. The type of pain, cause of the pain, and patient lifestyle are all contributing factors to this decision. That being said, common interventional pain management methods include: implantable devices (stimulators), injections (steroid, anesthesia, epidural), nerve blocks, physical therapy (massage, occupational/recreational therapy), trigger point injections, branch blocks, and Rhizotomy.

Pain management has come a long way from the simple prescription of medications with new, cutting-edge treatments always being implanted. We work to understand, treat, and prevent your pain so that you don’t have to be limited in living the life you love.



Simple Anatomy of the Spine

The spine is most commonly thought of and referred to as the backbone that lends itself to movement, functionality, and support of the human body. This is of course true, but rather than being made up of just one long sequence of vertebrae and joints, the spine is actually made up of three distinctive parts. These three parts of the spine are very important as they all support different operations and work together to protect the nerves of the spinal cord.

Cervical, Thoracic, and Lumbar Spine are medical terminology used during patient examinations and treatment. Since these three areas are so different, focusing on a specific area of the spine can help diagnosis and treatment of ailments to be more productive.

Cervical Spine:

The cervical spine refers to the uppermost area of the spine, running from the top of the shoulders to the neck and head. Seven vertebrae make up the cervical spine which has a natural slightly concave curve. The main function of the cervical spine is to support the head, which is not a task taken lightly as this burden bares an average weight of 10 pounds. This part of the spine also allows for the most extended range of motion through up-down as well as left-to-right rotation.

Thoracic Spine:

The thoracic spine is located in the middle region of the back and starts where the cervical spine left off. It is made up of 12 vertebrae that become increasingly larger down the back and forms a slight convex shape. The thoracic spine has the main function of supporting your ribs and protecting essential organs.

Lumbar Spine:

Finally, at the base of the back is the lumbar spine. There are 5 large vertebrae that make up this portion of the spine and connect to the Sacrum, or hips. The lumbar spine bears a substantial amount of body weight and is often the source of many people’s back pain for this reason.


The majority of procedures at Pain Specialists of Charleston and Columbia can be conducted in any of these areas of the spine.

To learn more about treatment options or to schedule an appointment give us a call!



More on Chronic Pain and How it can be Handled

Chronic pain is defined as pain that is on-going or persistent in nature. This pain can occur anywhere on the body and differs from acute pain, which usually arises as the result of a new ailment or injury. Like acute pain, chronic pain can begin as a side-effect of injury or illness but may have no clear cause in other cases.

Since pain is a subjective experience that differs for everyone, making a medical diagnosis can be difficult. In recent years, chronic pain has gained more public discussion and support but continues to be a somewhat controversial topic because of this. When explaining your pain to a physician, descriptions of the timeframe of occurrence, location(s), causes and pain sensations (tingling, sharp, throbbing, shooting, numbing, radiating, burning, aching, etc.) can help a doctor prescribe better and more individualized solutions.

For those suffering, their pain can cause many obstacles to everyday life and happiness. The goal of treatment is to reduce pain and improve function for the individual. While chronic pain cannot necessarily be cured, there are many options for managing this condition ranging from simple self-care to more invasive procedures.

If you or someone you know experiences chronic pain, consider scheduling an appointment with a pain specialist to learn about your options.

Support groups for additional resources, information and support:



September is Pain Awareness Month

September is Pain Awareness Month.

Over 100 million Americans currently suffer from chronic pain, with that number growing from year to year. People living with chronic pain, know just how debilitating it can be. But, what is chronic pain and how does it differ from regular pain?

Everyone will experience pain at some point, a sprained ankle or hurt back, but once the injury has healed, the pain is gone. Chronic pain is defined as a persisting pain that lasts for weeks, months, even years. With chronic pain, pain signals continue to send messages through the nervous system that something is wrong long after an injury has healed. Pain can stem from an initial incident (injury, infection, surgery) or from an ongoing condition (arthritic, migraines, fibromyalgia). Some people will suffer from chronic pain in the absence of injury or ongoing conditions.

Three of the most common forms of pain are back pain, headaches, and osteoarthritis.

Back pain is the second most common reason for doctor’s visits, with low back pain affecting over 31 million Americans. Back pain can cause numbness, tingling, shooting pains, and weakness in the legs. A number of things can cause back pain, from pulling a muscle when you lift a box to your posture to a serve accident. It is important to monitor any back pain you are having so it does not worsen.

Headaches are classified into three major categories: primary headaches, secondary headaches, and cranial neuralgias/ facial pain. Some of the symptoms include: nausea, sensitivity to light, blurry vision, pupils getting smaller, and feeling dizzy. It is important to know that during a headache, a person can experience many different symptoms that are not consistent from one headache to the next. When experiencing a headache it is best to try to relax in a cool, dark space.

Osteoarthritis is the most common form of arthritis and is caused by the breakdown of cartilage that protects your joints from rubbing together. It typically worsens over time and is more prevalent in women than men. It can also be seen in people who have played sports throughout their lives or who have had a job that requires a lot of kneeling/ lifting. Make sure to protect your knees when exercising and always let knee injuries heal.

When experiencing chronic pain, it is important to speak with your doctor about symptoms to determine the best plan of action to manage your pain and get you back to the life you love!


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