A Thoracic Epidural Steroid Injection (TESI) is a minimally invasive procedure designed to relieve pain in the mid-back, chest, ribs, or abdomen that may radiate to other parts of the body. It is commonly used to treat pain caused by:
- Herniated or bulging discs in the thoracic spine
- Spinal stenosis (narrowing of the spinal canal)
- Thoracic radiculopathy (nerve root compression or irritation)
- Degenerative disc disease
- Post-surgical pain in the thoracic region
- Shingles-related nerve pain (postherpetic neuralgia)
TESI works by delivering a corticosteroid (anti-inflammatory) and anesthetic to the epidural space around the affected nerves, reducing inflammation and relieving pain.
How Does It Help?
Steroid medication reduces inflammation, one of the main causes of nerve irritation. This often leads to relief of mid-back pain and related symptoms such as pain that radiates to the chest, ribs, or abdomen. While it doesn’t cure the underlying condition, this injection can provide lasting relief and enable you to engage in rehabilitation or physical therapy to improve long-term spine health.
Steps of Administering a Thoracic Epidural Steroid Injection
- Pre-procedure Preparation
- You will be positioned face down on a table, and the skin in the mid-back area will be cleaned with an antiseptic.
- A local anesthetic will be applied to numb the skin and surrounding tissues to make the injection more comfortable.
- Using Fluoroscopic Guidance
- The physician will use fluoroscopy (a real-time X-ray) to carefully guide a needle into the epidural space in your thoracic spine. This ensures that the medication is delivered precisely to the area of inflammation.
- Injection of Medication
- After the needle is in position, a contrast dye may be used to verify the correct location.
- The steroid medication, often mixed with a small amount of anesthetic, will be injected into the epidural space.
- Post-Procedure
- After the injection, you will be monitored for 15-30 minutes. You may feel some soreness at the injection site, which should resolve within a day or two.
When Can You Go Home?
- Most patients are able to go home within 30-60 minutes after the procedure.
- It is recommended to have someone drive you home as you may feel temporary weakness, numbness, or drowsiness.
- You should rest on the day of the procedure and avoid strenuous activities for at least 24 hours, after which you can gradually return to normal activities.
How Many Injections Are Needed?
The number of injections required depends on the severity of your condition and how you respond to the treatment. Typically, patients require 1 to 3 injections over a period of several weeks to achieve significant and long-lasting relief.
- Initial Relief: Some patients may experience relief after the first injection, while others may need 2 to 3 injections spaced a few weeks apart for optimal benefit.
- Long-term Relief: Pain relief can last from several weeks to several months, and additional injections may be recommended if the pain returns.
Final Thoughts
A thoracic epidural steroid injection is an effective way to manage mid-back pain caused by inflammation around the spinal nerves. While it is not a permanent solution for the underlying condition, this procedure can provide lasting relief and make it easier to participate in physical therapy or other treatments that promote healing and strengthen the spine.
If you have any questions about the procedure or your recovery, please don’t hesitate to reach out to our office for further guidance.