Epidural steroid injections

Epidural steroid injections (ESI) are used to treat chronic back pain or radiculopathy. Injecting corticosteroids and local anaesthetics into the epidural space in the spine effectively reduces local inflammation and relieves pain.

Epidural steroid injections are usually given to treat pain caused by:

  • Intervertebral disc herniation
  • Narrowing of the spinal canal (stenosis)
  • Degeneration or inflammation of the spinal joints

Procedure flow

  1. Preparation: You will need to sit or lie on your stomach. The injection site will be disinfected to reduce the soreness of the procedure and the skin will be anaesthetised with a local anaesthetic.
  2. Needle insertion: The doctor performing the procedure inserts a needle into the epidural space in the spine. In some cases, the injection is carried out under X-ray guidance and an iodine contrast agent is injected to confirm the needle position.
  3. Injecting medicines: A mixture of a steroid and an anaesthetic is injected into the epidural space. The injection is usually painless. The whole procedure usually takes about 15-30 minutes.
  4. Post-procedure: After the injection, the patient is observed for 30-60 minutes. In most cases, pain relief is felt immediately after the procedure. At the end of the observation period, the patient is discharged home.

Efficiency

The level and duration of pain relief from epidural steroid injections can vary. Many patients experience symptom improvement within a few days. The effect of the procedure is not assessed until after 2 weeks.

How to prepare for the procedure?

  • Know all the medicines you are currently taking.
  • Depending on the medication, you may be instructed to stop taking certain medications a few days before the procedure.
  • Wear loose, comfortable clothing.

Epidural steroid injections Price

Services

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SPECIALISTS

Dr Alfredas Vaitkus

Anaesthesiologist-anaesthesiologist, specialist in interventional pain management

Saulius Andruskevičius

Neurologist, specialist in interventional pain management

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OTHER SERVICES

Botulino toksino terapija

Diagnostinės injekcijos (blokados)

Epidurinė neuroplastika

Epidurinės steroidų injekcijos

Injekcijos šalia autonominės nervų sistemos mazgų

Injekcijos šalia periferinių nervų

D.U.K.

It is recommended to see a pain specialist if:

  • severe pain lasting for more than a few weeks and a specialist (e.g. neurologist, orthopaedic traumatologist) has identified the cause of the pain
  • regular painkillers prescribed by your GP or specialist doctor don’t help
  • the pain is getting worse
  • severe limitations in movement, daily activities and sleep

Our clinic treats all chronic or recurrent pain syndromes:

  • back pain
  • joint pain
  • pain caused by nerve irritation or damage
  • post-operative or post-traumatic pain
  • head and face pains
  • pain caused by widespread or damage to the central nervous system

For more information on the pain syndromes we treat, see Pain syndromes.

During your first consultation at our clinic:

  • a thorough assessment of the nature and history of your pain
  • reviewing the tests performed (e.g. MRI, CT, X-ray)
  • perform a clinical examination for pain
  • draw up an individual treatment plan and discuss it with you
  • if indicated and with the patient’s consent, interventional pain management procedures can usually be applied during the first consultation

No referral is required when visiting our clinic. However, before referring to a pain specialist, the patient’s pain should be evaluated by an appropriate medical specialist (e.g. neurologist, orthopaedic-traumatologist) and the cause of the pain should be identified. This is very important to avoid overlooking rarer specific diseases that require timely treatment outside the pain clinic.

Pain clinics are usually specialised in the assessment and treatment of pain, but do not diagnose the diseases that cause it.

If you have one, please bring it with you when you arrive:

  • magnetic resonance imaging (MRI) scans or descriptions
  • computed tomography (CT) scans or descriptions of them
  • X-rays or descriptions thereof
  • records of previous treatment or consultations
  • a list of medicines (for the treatment of pain and other conditions)

This information helps to make the diagnosis more accurate and faster, and to select the most appropriate treatment.

Usually, the best treatment results are achieved through a comprehensive approach to individually tailored treatment methods.

Clinic appointments may include:

  • painkillers
  • targeted injections of medicines (‘pain blocks’)
  • interventional radioiodine and cryoneurolysis procedures
  • electrical stimulation procedures (interventional and non-interventional)
  • physiotherapy
  • adjustments to activity, posture, working environment and other lifestyle changes

It is a minimally invasive treatment technique designed to precisely and selectively target the source of pain or the nerve structures that transmit pain. Procedures are usually performed under ultrasound or X-ray control to maximise precision and safety. Interventional pain treatment is selected on an individual basis, taking into account the patient’s condition, the cause of the pain and previous treatments.

Yes, the procedures are carried out under strict safety standards, usually using ultrasound or X-ray guidance. Complications are rare.

Most procedures are minimally painful because they use local anaesthesia. Patients usually experience only short-term discomfort.

Treatments usually last about 30 minutes. Afterwards, the patient is monitored in the ward for about an hour before being discharged home.

The effect can take a few days, in some cases within 1-2 weeks. This depends on the method of treatment used and the individual body’s response.

This depends largely on the pain syndrome, individual patient factors and the type of procedure used. Some interventions may have a short-term effect, while for example, after radiofrequency denervation, pain usually recurs gradually, with nerve regeneration taking 6-12 months. Effective pain treatments can be repeated.

The main goal of chronic pain treatment is to reduce pain, improve function and quality of life. In some cases, pain can be eliminated completely.

Yes, especially if the underlying problem causing the pain (e.g. degeneration of the spine or joints) is not solved. Continuous patient care, pain prevention and multidisciplinary treatment are important for long-term results.

Mostly yes. It is recommended to avoid strenuous exercise the day after the procedure and to follow your doctor’s recommendations. Afterwards, you can return to your normal activities.

The cost of treatment depends on:

  • type of consultation
  • the complexity and duration of the procedure
  • technologies used

The exact price is discussed individually during the consultation.

For more information, see Prices.

All our services are chargeable.

A pain doctor specialises in assessing pain syndromes and selecting the most appropriate pain treatment methods. Some pain treatment methods are only used by interventional pain specialists.

This allows:

  • diagnosing pain syndrome more accurately
  • more effective treatment
  • reducing the need for medicines

Advice and news

Supplementary short text

“Skausmo centras – a new specialised pain clinic in Vilnius to open in June

This June, the Pain Centre will open its doors at Rezus Medical Centre, Santaros g. 5, as …

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Pain doesn't have to become part of your daily routine

Regain your quality of life with our help

Pain doesn't have to become part of your daily routine

Regain your quality of life with our help