An epidural steroid injection (ESI) is a procedure that can be done to help relieve neck, arm, back, and leg pain caused by inflamed spinal nerves. An epidural steroid injection can be performed to relieve pain due to spondylolysis, spinal stenosis, or disc herniation. Medicines are delivered to the spinal nerves through the epidural space, the area between the protective covering of the spinal cord and vertebrae. Steroid injections can reduce inflammation and are effective when delivered into the painful area. Epidural steroid injections can also help determine if surgery might be beneficial for pain associated with a herniated disc. Many patients experience pain relief from multiple injections. Pain relief from injections may last for several days or even several years. There are 4 areas an ESI can be performed on. A cervical epidural steroid injection is performed for pain associated with the neck, shoulder, and arms. A thoracic epidural steroid injection can be performed to gain relief from pain in the mid-back or the rib cage. A lumbar epidural steroid injection is done for many forms of low back pain and leg pain. The caudal epidural steroid injection is located at the base of the spine, above the tailbone. It is also performed to alleviate low back pain and leg pain. The caudal approach is especially useful in those patients who have previously undergone low back surgery. This approach is also optimal in patients who are anti-coagulated. With few risks, epidural steroid injections are considered an appropriate non-surgical treatment.