Thoracic Epidural Steroid Injection

A Thoracic Epidural Steroid Injection (TESI) is a minimally invasive procedure used to relieve pain caused by inflammation or irritation of the nerves in the mid-back region. By delivering corticosteroid and anesthetic medication directly into the epidural space around the spinal nerves, this treatment reduces swelling, calms nerve irritation, and helps alleviate pain that radiates from the mid-back into the chest or abdomen.

Quick facts

  • Setting: Outpatient, image-guided
  • Time: ~20–30 minutes
  • Anesthesia: Local with optional light sedation
  • Recovery: Same-day discharge; mild soreness for 1–2 days
  • Duration of relief: Weeks to months; repeat injections may be recommended

Who it helps

  • Thoracic disc herniation or bulging disc
  • Spinal stenosis or nerve compression in the mid-back
  • Thoracic radiculopathy (pain radiating around the chest or ribs)
  • Post-surgical back pain or nerve inflammation
  • Chronic mid-back pain unrelieved by conservative care

How it works

The epidural space surrounds the spinal cord and nerve roots. When these nerves become inflamed or compressed, pain can spread through the thoracic region and into the chest or abdominal wall. During a thoracic epidural steroid injection, your provider uses fluoroscopic (X-ray) guidance to place a thin needle into the epidural space. A mixture of corticosteroid and local anesthetic medication is injected, reducing inflammation and easing pain caused by irritated nerves.

What to expect

  • Before: Your provider will review your medical history and imaging. You may be advised to stop blood thinners or certain medications before the procedure.
  • During: You’ll lie comfortably on your stomach. After numbing the skin, your provider inserts a small needle into the epidural space using real-time X-ray guidance and injects medication.
  • After: You’ll rest briefly in recovery before going home. Some temporary soreness or numbness may occur. Pain relief typically begins within several days and continues to improve over the next week.

Benefits & risks

Benefits:

  • Reduces inflammation and swelling around spinal nerves
  • Provides relief from mid-back and radiating chest pain
  • Improves mobility and function
  • Minimally invasive and outpatient-based

Risks:

  • Temporary increase in pain before improvement
  • Infection, bleeding, or headache (rare)
  • Allergic reaction to medication (rare)
  • Temporary numbness or weakness in nearby areas

Is it right for me? (Checklist)

  • ✅ Persistent mid-back pain or radiating pain from nerve inflammation
  • ✅ Imaging shows disc herniation or nerve compression in the thoracic spine
  • ✅ Symptoms not relieved by medication, rest, or physical therapy
  • ✅ Suitable candidate for an image-guided outpatient procedure

Alternatives at PCET

FAQs

  • When will I feel relief? Many patients begin noticing improvement within 3–5 days as inflammation decreases.
  • How long does relief last? Relief may last weeks to months; results vary depending on the condition.
  • Can I repeat the procedure? Yes—repeat injections can safely extend pain relief if symptoms return.
  • Is it painful? Most patients tolerate the procedure well; local anesthesia minimizes discomfort.
  • Is it covered by insurance? Most insurance plans, including Medicare, cover epidural steroid injections when medically indicated.

📞 Call to Schedule

If you’re living with chronic pain and want to explore advanced, non-opioid treatment options, a Spinal Cord Stimulator Trial may be right for you. Call us at 865-934-2567 to schedule your appointment today.