Thoracic Epidural Steroid Injection in Cincinnati - APSI Wellness
Learn about thoracic epidural steroid injections for mid-back pain and thoracic nerve root irritation at APSI Wellness in Cincinnati.
Thoracic Epidural Steroid Injection — A thoracic epidural steroid injection delivers anti-inflammatory medication into the epidural space of the mid-back to treat pain from thoracic disc herniations, spinal stenosis, and nerve root inflammation.
What Is a Thoracic Epidural Steroid Injection?
A thoracic epidural steroid injection (TESI) delivers corticosteroid medication into the epidural space of the thoracic (mid-back) spine. The thoracic spine spans from the base of the neck to the bottom of the rib cage and is less commonly affected by disc herniations or stenosis than the lumbar or cervical spine — but when thoracic nerve roots become compressed or inflamed, the resulting pain can be significant and debilitating.
How Does It Work?
The epidural space in the thoracic spine surrounds the spinal cord and the nerve roots that exit at each thoracic level. These nerve roots travel along the rib cage as intercostal nerves. When inflammation from disc herniations, bone spurs, or stenosis affects these nerve roots, the injection delivers:
Corticosteroid to reduce swelling and inflammation around the affected nerves
Local anesthetic for immediate temporary pain relief
Medication is delivered under fluoroscopic guidance for safety and accuracy
Conditions Treated
Thoracic disc herniation — disc material compressing thoracic nerve roots
Thoracic spinal stenosis — narrowing of the thoracic spinal canal
Thoracic radiculopathy — nerve root pain radiating along the rib cage
Degenerative disc disease — in the thoracic spine
Post-thoracotomy syndrome — persistent pain after chest surgery
Herpes zoster (shingles) pain — acute pain from thoracic dermatome shingles
What to Expect During the Procedure
Before: Stop blood-thinning medications as directed. Arrange for a driver.
During: You'll lie face-down. The physician uses fluoroscopy to identify the target thoracic level. After sterile preparation and local anesthesia, a needle is carefully advanced into the thoracic epidural space using a loss-of-resistance technique. Contrast dye confirms proper placement. The medication is slowly injected. The procedure takes 20-30 minutes.
After: You'll be monitored for 30 minutes. Some patients notice immediate partial relief from the anesthetic. The steroid takes 3-7 days for full effect. Mild soreness at the injection site is normal. Resume normal activities within 24-48 hours.
Benefits
Targeted delivery of anti-inflammatory medication to the thoracic spine
Can provide significant relief from mid-back and intercostal pain
Minimally invasive outpatient procedure
Helps patients engage in physical therapy
Can provide weeks to months of relief
May prevent the need for thoracic spine surgery
Risks and Side Effects
Injection site soreness
Temporary increase in mid-back pain
Headache (from dural puncture, rare)
Temporary numbness or weakness (rare)
Infection (very rare)
Spinal cord injury (extremely rare with proper technique)
Frequently Asked Questions
Is a thoracic epidural more difficult than a lumbar epidural?
The thoracic spine has narrower epidural space and more acute spinous process angulation than the lumbar spine, which requires additional technical expertise. At APSI Wellness, our physicians are experienced in performing thoracic epidural procedures safely.
Can thoracic epidural injections treat rib pain?
Yes. The intercostal nerves that supply sensation to the rib cage originate from thoracic nerve roots. A thoracic epidural can reduce inflammation at these nerve roots, treating pain that radiates along the ribs.
How many thoracic epidural injections can I have?
Most physicians recommend up to 3 injections within a 12-month period. If the first injection is effective, a second may be performed to extend the benefit.
Will this help my shingles pain?
Thoracic epidural steroid injections can be beneficial during an acute shingles outbreak in the thoracic area, reducing inflammation and potentially decreasing the risk of developing post-herpetic neuralgia.
How do I know if my mid-back pain needs an epidural?
If your mid-back pain radiates along the rib cage, is accompanied by numbness or tingling, and hasn't responded to conservative measures like physical therapy and oral anti-inflammatories, you may be a candidate for a thoracic epidural injection.
APSI Wellness — Advanced Pain Solutions & Interventions
5405 DuPont Circle Suite A, Milford, OH 45150 | Phone: (513) 936-3050
https://apsiwellness.com/services/thoracic-epidural-steroid-injection