Thoracic Epidural Steroid Injections

A thoracic epidural steroid cortisone injection is a treatment designed to relieve pain in the upper back and shoulder areas. The specific pain could result from severe inflammation or a pinched nerve in the thoracic region of the spine, which comprises your upper and back middle areas. Thoracic epidural cortisone steroid injections reduce inflammation in the affected area and provide pain relief.

The cortisone injection is a way to deliver steroids and anesthetics right into the nerves in the spinal roots, providing immediate pain relief. Your Midtown Manhattan sports medicine and pain management doctor uses cortisone injections as temporary pain relief to give your body time to heal. The thoracic epidural steroid cortisone injection (cortisone shot) is highly effective and significantly reduces pain more than 50 percent of the time.

Reasons You May Need a Thoracic Epidural Cortisone Steroid Injection

Back pain is one of the main complaints your doctor hears for many reasons. Whether you’re an active weekend golfer, a professional athlete, or a worker who sits in front of a computer all day, you can develop thoracic spine pain.

Common causes that lead to your need for thoracic epidural cortisone steroid injections include:

Herniated disc
Spinal stenosis
Facet joint syndrome
Degenerative disc disease
Compression fractures
Torn or stretched tendons
Cysts

Diagnosing Your Thoracic Spine Pain

Prepare to give your doctor details about any trauma you may have had recently that seemed to coincide with your back pain. A thorough history of previous back problems and your activity level also help him reach a clear diagnosis.

Diagnostic tests may include x-rays, CT scans, or MRIs, which can help your doctor rule out other causes of pain, such as tumors. If you’re pregnant, taking blood thinners, or have an infection, you may not be eligible to receive a thoracic epidural cortisone shot.

Cortisone Shot: What to Expect

The procedure is beneficial for all kinds of diagnoses, including upper back pain, middle back pain, and back injuries that cause thoracic back pain.

For your safety, don’t take any pain relief or anti-inflammatory medications before the procedure. Talk to our top-rated sports medicine specialist in NYC about what to eat and what medications are allowed before the cortisone shot. The steps taken for the thoracic epidural steroid injection include:

You’re asked to lie on your stomach on a fluoroscopy table that provides real-time x-rays to help your doctor diagnose the needle. You may be offered a sedative to relax during the procedure if you’re nervous.
The area of the cortisone injection site is then cleansed and sanitized with an antibacterial solution and prepped for the initial injection.
A numbing agent is applied to the cortisone injection site, so you don’t feel the needle. The numbing agent might give you a slight sting.
Next, the needle with the medication is injected into the spot deemed to be the source of your pain.

The entire procedure very often takes just 10 minutes or less. After the procedure, you’re asked to stay in the recovery room for anywhere from 15 to 60 minutes for observation. It’s normal to feel slight discomfort or soreness in the area of the cortisone shot. An ice pack at home for the first day or two helps alleviate this soreness.

After Cortisone Shot Treatment and Recovery

Within about 48 to 72 hours of your injection, the effects of the treatment begin to take effect. You receive the intended relief in the injured part of your spine.

Follow-up appointments are necessary with your Manhattan pain management doctor because thoracic epidural steroid cortisone injections typically are done in a series of three shots, each about two weeks apart, depending on the severity of your pain and the success of the first epidural.

Side Effects and Benefits

You may experience immediate pain relief in your upper back and shoulders, indicating that the injection was put in correctly. If pain continues, however, during the following days, and a tender or sore feeling returns to the location of the cortisone shot, you may be experiencing a rare side effect that could include:

Bruising
Swelling at the site of the cortisone injection
Increasing local pain
Infection
Facial flushing
Nerve damage

Most of these side effects usually dissipate within 24 hours. Thoracic epidural steroid injections or cortisone shots are safe and highly effective, but serious side effects can occur. Call your doctor if you experience:

Headaches while you’re standing or sitting up that feel better when you lie down
Fever that lingers for more than 24 hours
Losing bowel or bladder control
Loss of arm or leg function
Severe pain

Febin Melepura, MD is a top rated, best in class interventional pain management doctor. He is a nationally recognized pain relief specialist and is among the top pain care doctors in New York City and the country. He is an award winning expert and contributor to a prominent media outlets.

Dr. Febin Melepura has been recognized for his thoughtful, thorough, modern approach to treating chronic pain and, among other accolades, has been named a “top pain management doctor in New York”, and one of “America’s Top Doctors™” for an advanced sports injury treatments.