An “ESI” can be an option in the management of radiating nerve pain, or “radiculopathy” when it originates from the spinal structures, usually a “pinched nerve” from a herniated disk or stenosis (see above). This is a minimally invasive procedure that is performed with “real time” x-ray guidance, or what is called “fluoroscopy”. A needle specifically designed for this type of procedure is carefully guided into the epidural space where the “nerve” lives, and after contrast confirms appropriate placement, a combination of a steroid and saline/anesthetic is injected through the needle. It is done at the level of the spine that correlates with imaging and the patient’s symptoms. ESI’s can be performed at essentially any part of the spine, have the potential to reduce pain temporarily. ESI’s are a part of a comprehensive treatment plan that may include oral medication and physical therapy.