Epidural Steroid Injections vs. Other Pain Injections: What’s Right for You? | Wisteria Health
ESI or Nerve Block? Choosing the Right Injection for Spinal Pain
If you're dealing with chronic neck, back, or nerve-related pain, your provider may recommend an injection to reduce inflammation and help you feel better. But with several options available, like epidural steroid injections (ESIs), nerve blocks, and facet joint injections, how do you know which one is right for you?
At Wisteria Health, we tailor pain treatments to your condition, imaging results, and goals. In this post, we’ll break down the differences between ESIs and other common spinal injections, so you feel confident asking questions and making decisions with your care team.
What Is an Epidural Steroid Injection (ESI)?
An epidural steroid injection delivers a combination of anti-inflammatory medication (typically a corticosteroid) and local anesthetic into the epidural space: the area around the spinal nerves. This reduces swelling and irritation that can cause pain, numbness, or tingling that radiates down the arms or legs.
ESIs are commonly used to treat:
Herniated discs
Spinal stenosis
Sciatica or nerve root compression
Chronic inflammation affecting the cervical or lumbar spine
If you’ve had pain that hasn’t improved with physical therapy or medications, an ESI may be a next step before considering surgery.
ESI vs. Nerve Blocks: What’s the Difference?
While both ESIs and nerve blocks involve injections near the spine, they’re used for different purposes.
A nerve block is more focused and often diagnostic; it targets a specific nerve suspected of causing pain. If your pain improves after the injection, it confirms the nerve is involved and may guide further treatments like radiofrequency ablation or peripheral nerve stimulation.
In contrast, an ESI is broader and typically used for therapeutic relief of widespread inflammation affecting multiple spinal nerves. Some patients benefit from both, depending on how their pain presents.
Other Injection Options
Besides ESIs and nerve blocks, other interventional injections we may consider include:
Facet joint injections: For arthritis-related pain from spinal joints
Sacroiliac (SI) joint injections: For pain in the lower back and pelvis
Trigger point injections: For muscle tension and localized soft tissue pain
Each injection is designed to target a specific structure, joints, nerves, or muscle groups, based on your exam and imaging results.
How We Help You Decide
No two pain cases are the same. At Wisteria Health, your provider will evaluate your history, symptoms, imaging (MRI, CT, or X-ray), and response to prior treatments. We may start with a nerve block to gather information, then follow with an ESI for broader relief, or vice versa.
If you’ve had injections in the past that didn’t work, don’t worry. The key is matching the right technique to the right diagnosis at the right time.
What to Expect from an ESI
Epidural steroid injections are performed in an outpatient setting with live X-ray guidance for accuracy. The procedure typically takes less than 30 minutes, and you can go home the same day. Some patients feel relief within a few days, while others need a short series of injections spaced over time.
You can learn more about the procedure on our Cervical & Lumbar ESI page or explore our full range of interventional pain treatments.
Considering a Spinal Injection?
Whether you’re dealing with back pain, radiating leg symptoms, or recovering from an injury, Wisteria Health is here to help you explore safe, effective, and evidence-based solutions.
We also offer transparent self-pay pricing and accept most major insurance plans.
Contact us today to schedule a consultation and find out which injection therapy is right for you.