Thoracic Epidural Steroid Injection
A thoracic epidural steroid injection (TESI) delivers anti-inflammatory steroid medication into the thoracic epidural space — the area surrounding the spinal cord in the mid-back region (T1 through T12 vertebrae). This procedure addresses pain originating from thoracic disc herniation, thoracic spinal stenosis, or nerve root compression in the middle portion of the spine.
Conditions Treated
Thoracic nerve root compression is less common than cervical or lumbar pathology, but when it occurs, it causes a characteristic pattern of symptoms:
- Mid-back pain at a specific vertebral level
- Band-like pain that wraps around the chest or abdomen (intercostal radiculopathy)
- Post-herpetic neuralgia (shingles pain) — a very common indication for thoracic epidurals
- Thoracic disc herniation with thoracic myelopathy symptoms
- Compression fracture pain with radicular component
The Procedure
Thoracic epidural injections require particular care given the relatively narrow epidural space in this region and the proximity to the spinal cord. Dr. Rubin performs all thoracic epidurals under fluoroscopic guidance using the loss-of-resistance technique with contrast confirmation.
You lie face-down on the procedure table; the skin and soft tissues are numbed, and the needle is advanced carefully to the epidural space under continuous X-ray imaging. The procedure takes approximately 20–30 minutes.
Post-Herpetic Neuralgia (Shingles Pain)
One of the most common reasons for a thoracic epidural is lingering pain after a shingles outbreak — called post-herpetic neuralgia (PHN). The viral infection causes damage to thoracic nerve roots, resulting in burning, stabbing, or electric-quality pain in a band across the chest or abdomen. Thoracic epidural steroid injections, sometimes combined with antiviral medications and neuropathic pain medications, can provide significant relief.
Contact Us
Call 516-492-3100 to discuss whether a thoracic epidural steroid injection may help your mid-back or chest wall pain.