Epidural Steroid Injections

Epidural steroid injections (ESI) are an important part of our non-surgical approach to pain management. While the injection alone is often enough to offer relief, we commonly provide a comprehensive rehabilitation program as well to help manage the pain.

The epidural space is the fluid-filled area that surrounds the spinal cord. An epidural is a small, thin tube that can be inserted into a fluid-filled area that surrounds the spinal cord. This helps ease discomfort and relieve pain.

While epidurals are commonly given to women during childbirth, our team can also give them to children if needed.

Both adults and children can receive an epidural steroid injection. In adults, they’re commonly used to relieve different forms of low back pain and leg pain, including sciatica. It can also relieve neck, and thoracic pain. In children, epidurals are often used to help relieve after surgery.

A benefit of using an epidural is that it provides effective pain relief but does not cause drowsiness. In most cases, the anesthesiologist will administer the epidural after putting your child to sleep for their surgery.

An epidural is a small, thin tube that connects to a pump holding pain control medicine. Once we place it in the patient’s back, we will tape it in place to secure it.

Our team takes great care to administer an ESI injection as comfortably as possible. Your child should not feel the injection when it occurs, and the tube itself is so small that most children will not notice it when it’s placed.

The only thing they may feel is a gentle tugging on their back where the tape is located. They will feel the tape when it’s applied in the beginning, as well as when it’s removed.

The side effects of epidural injection are typically mild and minimal.

Once the pain medicine enters the bloodstream, the patient may experience mild side effects including nausea and itchiness. They may also feel a tingling sensation in their toes. While these reactions are normal, let your nurse or doctor know if your child experiences them so they can help them manage their symptoms and improve their comfort.

If your child expresses that they’re in pain, be sure to let a surgical team member know. Pain left untreated can cause severe discomfort and could possibly hinder their recovery.

We understand it can be difficult for children to express how much pain they’re in, or to tell us their level of discomfort. This is especially true for our littlest patients.

When this is the case, a nurse may use an illustrated pain scale with numbers or faces to help your child point out how they feel. They can select the number or face that most closely matches how they feel, and we can use this to determine next steps.

The epidural will remain in place in your child for a few days after their surgery. We will always remove the epidural tubing before releasing your child to go home.

Note that while the injection is normally enough to control your child’s pain, some children may require other types of pain medicine once we remove the tube. Your nurse or doctor will explain the type of pain medication prescribed and demonstrate how to administer it.

Once your child has fully recovered from surgery, they will be allowed to go home. Once we remove the epidural, our surgical team will watch your child closely to monitor their level of pain and make sure it’s tolerable. If we don’t see a running fever and they are eating and drinking, they can be discharged. Children who require additional pain medicine must be able to take it orally before going home.

If you notice any adverse side effects once your child is home, reach out to our team. We can guide you on next steps and provide additional treatment if needed. If any of the following symptoms occur, contact us immediately:

• Fever over 101 degrees Fahrenheit
• Diarrhea
• Vomiting
• Increased abdominal pain
• Loss of appetite

Also, monitor the site of their surgical incision closely. If it appears to be red, inflamed or draining fluid, call your doctor as soon as possible to schedule a follow-up appointment.

Beaumont Children’s provides expert-level medical care to everyone in your family, including the smallest members. Our network includes 400 pediatricians and 100 specialists, who are highly trained in almost every medical and surgical pediatric sub-specialty.