HF 5120

Epidural Steroid Injection (ESI) and Nerve Root Block (NRB)

Your doctor suggests an epidural steroid injection or nerve root block to help decrease the pain in your shoulder, neck, low back and/or leg. The level that is treated is based on your symptoms and imaging studies. The amount of pain relief felt from this treatment varies from patient to patient. Some patients do not get any pain relief. Many get some or total relief of their pain. Relief can last for two weeks to more than one year.

How to Prepare

You cannot have this treatment if:

  • You haven’t had an MRI or CT scan of your spine.

  • You have an active infection, such as a cold or sinus infection.

  • You may be or are pregnant.

  • You weigh more than 420 pounds.

Please tell our staff if you are taking blood thinners, such as, Plavix®, Warfarin (Coumadin®), Xarelto, or Pradaxa.

If you have diabetes, steroids will cause your blood sugar to increase. Make sure your primary doctor is aware of your scheduled injection; and, you have a plan to keep your blood sugar within your normal range.

Please bring your pain medicine with you. You may take it after your treatment, if needed.

You must have someone drive you home after your treatment, please plan for this. Some patients have weakness after treatment.

Day of Treatment

If your treatment is at University Hospital, enter through the clinic entrance and take the Atrium elevators to the 3rd floor. Check in at the (G3/3) Radiology desk.

If your treatment is at UW Health at The American Center, enter the hospital entrance and check in at reception desk. After checking in please have a seat in the waiting room next to the main entrance, across from the information desk on the 1st floor.

If you have an MRI or CT from another hospital, you must bring it with you for the Radiologist to review.

Tell your doctor if you have diabetes or heart problems.

The Radiologist will meet you in a consult room to explain the risks and benefits of the treatment. You will have a chance to ask questions you have before your treatment. Your treatment will take about 45 minutes. You will lie on your stomach for low back injection or your back for neck injections. A fine needle will be placed into your back or neck to place medicine around the nerves.

After Treatment

Most patients do not have any problems after treatment. There is a slight risk of infection or bleeding in the spine.

For 1-2 days after treatment, some patients may have:

  • For lower back injections, back or leg pain that is worse for a short time.

  • For neck or upper back injections, neck or shoulder pain that is worse for a short time.

  • Redness and flushing around the face.

  • Fluid gain for 1-2 days, which may affect breathing if they have heart problems.

  • High blood sugars if they have diabetes.

Treatment may cause a change in menstrual cycle. Patients could have spotting between periods. If you have periods and they change for more than 2 cycles, you should call your doctor to see if you need to be checked.


  • You must take the rest of the day off from work.

  • Avoid any heavy physical activity or heavy lifting for 24 hours.

  • You may return to your normal routine as soon as you feel able.

  • Pain

  • You may take the medicines that you use for your prior pain.

  • You will be given a pain log to fill out for the next 14 days. Please complete this form and mail it back to us. We will need this information to help decide the next step in your treatment plan.

  • Once your pain log is completed, contact the clinic who ordered your treatment to let them know how much pain relief you have. Please contact them sooner if you have any questions about more treatment.

When to Call

  • Pain that gets worse in your lower back

  • Chills

  • Fever over 100.4 F by mouth for 2 readings taken 4 hours apart

  • Redness or swelling around the site that gets worse

  • Any drainage from the site

Who to Call

Musculoskeletal Radiology Interventional Service
(608) 263-9729 option #3

If you are unable to keep your appointment, please call Radiology Scheduling at (608) 263-9729.

After hours, nights, weekends and holidays, call (608) 263-6400. Ask for the radiology resident on call. Leave your name and phone number with area code. The doctor will call you back.

The toll-free number is 1-800-323-8942.

If you are a patient receiving care at UnityPoint – Meriter, Swedish American or a health system outside of UW Health, please use the phone numbers provided in your discharge instructions for any questions or concerns.