Epidural Steroid Injections (ESIs) are one of the most effective treatments for neck, back, and radiating nerve pain. But the success of an ESI depends on one critical factor: Accuracy.

Placing medication near the irritated nerve root requires precision — and that’s why imaging guidance is essential.

At Genesis Wellness and Pain, ESIs are performed using fluoroscopy (live X‑ray) or ultrasound to ensure safe, accurate placement every time.

Why Imaging Guidance Is Essential

1. Precise Needle Placement

Fluoroscopy allows providers to see the spine in real time, ensuring the needle reaches the exact epidural space.

2. Improved Safety

Imaging reduces the risk of:

• Misplacement
• Vascular injection
• Tissue injury
• Ineffective treatment

3. Better Pain Relief

Accurate placement means medication reaches the inflamed nerve root — where it can actually help.

4. Confirmation of Correct Location

Contrast dye is used under fluoroscopy to verify that medication will flow to the correct area.

5. Avoiding Blind Injections

Blind ESIs (performed without imaging) are less accurate and carry higher risk — they should never be used for spine injections.

Fluoroscopy vs. Ultrasound: What’s the Difference?

Fluoroscopy (Live X‑Ray)

Best for:

• Cervical ESIs
• Lumbar ESIs
• Radiating arm or leg pain
• Disc‑related inflammation

Fluoroscopy provides a clear view of the spine and epidural space.

Ultrasound

Best for:

• Soft‑tissue injections
• Certain nerve blocks
• Patients who cannot receive contrast dye

Ultrasound allows real‑time visualization of nerves and surrounding tissues.

Why Imaging Guidance Improves Outcomes

Patients experience:

• Faster relief
• Fewer complications
• More predictable results
• Better mobility
• Improved ability to participate in physical therapy

Accurate injections lead to better long‑term outcomes.

What Patients Can Expect During an Image‑Guided ESI

• The skin is cleaned and numbed
• Imaging equipment is positioned
• The needle is guided precisely into the epidural space
• Contrast dye confirms correct placement
• Medication is injected safely and accurately

Most procedures take less than 30 minutes.

Imaging guidance is the gold standard for Epidural Steroid Injections. At Genesis Wellness and Pain, fluoroscopy and ultrasound ensure every injection is performed with accuracy, safety, and confidence — giving patients the best chance for meaningful relief.