Digital illustration of a glowing spine with energy waves, representing pain relief.

Easing Back Pain: Understanding Epidural Steroid Injections and Finding the Right Approach for You

Lena Voss in Health & Wellness December 2025 • 4 min read.

"A national survey of Korean pain physicians reveals insights into the use of epidural steroid injections (ESIs) for managing back pain and radiculopathy, highlighting variations and consensus in treatment approaches."

Back pain. It’s a common complaint, and for many, it can be debilitating. One of the go-to procedures for those suffering from lower back pain and radiculopathy (pain that radiates down the leg) is an epidural steroid injection, or ESI. But what exactly constitutes the 'right' way to administer these injections? Is there a consensus among medical professionals?

To answer these questions, a detailed survey was conducted among academic pain centers and select private practices in Korea. The goal was to understand the current practices and identify any common ground in how ESIs are performed.

This article dives into the findings of this survey, shedding light on the different approaches to ESIs and offering valuable insights for anyone considering this treatment option.

What the Survey Says: Key Findings on Epidural Steroid Injections

Digital illustration of a glowing spine with energy waves, representing pain relief.

The survey cast a wide net, gathering responses from 122 pain centers out of 173 initially contacted—a solid 70.5% response rate. This included feedback from 39 academic programs and 85 private practices, giving a well-rounded view of ESI practices.

So, what did the survey uncover? Here’s a breakdown of the key findings:

Steroid Choice: Over half (55%) of the physicians surveyed preferred dexamethasone for ESIs.
Injection Intervals: A notable difference emerged between academic institutions and private practices regarding the minimum interval between injections. Academic centers averaged 3.1 weeks, while private practices averaged 2.1 weeks (a statistically significant difference with a P value of 0.01).
Consistency in Approach: Despite some variations, the survey found no significant differences between academic institutions and private practices in terms of the types and single doses of steroids used, the annual steroid doses, or how doses were adjusted for patients with diabetes. The exception, as noted above, was the minimum interval between injections.

These findings suggest that while there's a common preference for certain steroids, the timing of injections can vary based on the practice setting. Let's explore what this means for you as a patient.

What Does This Mean for You? Navigating Your ESI Options

The survey highlights that while ESIs are a common procedure, approaches can vary. This underscores the importance of having an open discussion with your doctor about your specific needs and concerns. Don't hesitate to ask about the type of steroid being used, the reasons behind the chosen injection interval, and how the treatment plan will be adjusted if you have diabetes or other health conditions.

About this Article -

This article was crafted using a human-AI hybrid and collaborative approach. AI assisted our team with initial drafting, research insights, identifying key questions, and image generation. Our human editors guided topic selection, defined the angle, structured the content, ensured factual accuracy and relevance, refined the tone, and conducted thorough editing to deliver helpful, high-quality information.See our About page for more information.

This article is based on research published under:

DOI-LINK: 10.3344/kjp.2014.27.1.35, Alternate LINK

Title: Epidural Steroid Injection In Korean Pain Physicians: A National Survey

Subject: Anesthesiology and Pain Medicine

Journal: The Korean Journal of Pain

Publisher: Korean Pain Society

Authors: Eun Jung Kim, Jee Youn Moon, Keun Suk Park, Da Hye Yoo, Yong Chul Kim, Woo Seog Sim, Chul Joong Lee, Hwa Yong Shin, Jae Hun Kim, Yeon Dong Kim, Se Jin Lee

Published: 2014-01-31

Everything You Need To Know

What is an Epidural Steroid Injection (ESI) and how does it work?

An Epidural Steroid Injection (ESI) is a medical procedure used to alleviate back pain and radiculopathy. It involves injecting steroids into the epidural space, the area around the spinal cord and the nerve roots. This helps to reduce inflammation and pain. The findings of the survey, specifically the preference for using dexamethasone for ESIs, shows the specific approach used by physicians for pain management.

Why are the survey findings on Epidural Steroid Injections (ESIs) important?

The survey's findings are significant because they highlight variations in how Epidural Steroid Injections (ESIs) are administered. While there is a consensus on certain aspects, such as steroid choice and doses, the minimum interval between injections varied significantly between academic institutions and private practices. This information is crucial for patients to understand that treatment approaches can differ depending on the healthcare setting and helps them have informed discussions with their doctors about their specific needs. The p value of 0.01 shows that there is a statistically significant difference in injection intervals between academic and private practices.

How does the choice of steroid affect my treatment with Epidural Steroid Injections (ESIs)?

The choice of steroid is an important consideration when discussing Epidural Steroid Injections (ESIs) with your doctor. The survey found that dexamethasone was the preferred steroid among the physicians surveyed. The choice of steroid impacts the efficacy and potential side effects of the injection. You should discuss with your doctor the specific steroid being used and why it is the most suitable option for your condition and health profile. Understanding the chosen steroid helps in managing expectations and monitoring for any adverse reactions.

How often can I get Epidural Steroid Injections (ESIs)?

The frequency of Epidural Steroid Injections (ESIs) can vary, as indicated by the survey findings. Academic institutions and private practices may have different approaches to the minimum interval between injections. The survey indicated that academic centers averaged 3.1 weeks between injections, while private practices averaged 2.1 weeks. It is important to discuss the injection interval with your doctor, as it can affect the effectiveness of treatment and the potential for side effects. Understanding the rationale behind the chosen interval will help you manage your treatment plan effectively.

Do Epidural Steroid Injections (ESIs) need to be adjusted if I have diabetes or other health conditions?

Having diabetes or other health conditions necessitates a tailored approach to Epidural Steroid Injections (ESIs). The survey indicated no significant differences in how doses were adjusted for patients with diabetes. You should inform your doctor about any health conditions you have so they can customize the treatment plan. Open communication with your doctor is essential to ensure that the Epidural Steroid Injection (ESI) is safe and effective, considering your overall health and any potential medication interactions or complications. The article doesn't go into the details of how the doses are adjusted, but the results show that it is accounted for.