Overview
The thoracic spine contains nerves that supply the mid‑back, ribs and parts of the chest wall. When these nerves become inflamed—due to disc irritation, joint problems, muscular strain or postural overload—they may trigger persistent pain, tingling or radiating discomfort around the ribs.
A thoracic epidural injection places anti‑inflammatory medication into the epidural space surrounding the affected nerves. This aims to calm irritation, reduce pain signals and support recovery. The procedure may be used for both diagnostic and therapeutic purposes.
Who this treatment helps
A thoracic epidural injection may be considered for people with:
- Mid‑back pain radiating around the ribs or chest
- Nerve‑related symptoms such as tingling, burning or numbness
- Pain aggravated by twisting, deep breathing or prolonged posture
- Thoracic disc bulges or nerve root irritation
- Persistent symptoms despite physiotherapy or medication
- Pain patterns suspected to originate from thoracic nerve inflammation
A consultation is required to confirm suitability and ensure the symptoms match a pattern that may respond to epidural treatment.
What is a Thoracic Epidural Injection?
This procedure involves placing a fine needle into the epidural space of the thoracic spine. A mixture of local anaesthetic and steroid medication is then delivered around the inflamed nerve roots. The steroid aims to reduce inflammation, while the local anaesthetic may provide temporary numbing to help confirm the source of pain.
Fluoroscopy (X‑ray guidance) is commonly used to optimise accuracy and safety. The injection is performed by a consultant pain specialist in a controlled clinical environment.
What to expect during the procedure
- Your consultant reviews the plan and answers any final questions.
- You lie comfortably on the procedure table, usually face down.
- The skin of the mid‑back is cleaned and numbed with local anaesthetic.
- Using imaging guidance, a fine needle is positioned in the epidural space.
- A small amount of contrast dye may be used to confirm placement.
- The steroid and local anaesthetic mixture is injected.
- You are monitored briefly before going home the same day.
The procedure typically takes 15–30 minutes.
After the procedure
- Temporary numbness or heaviness in the mid‑back or chest wall may occur and usually settles within hours.
- Some soreness at the injection site is normal.
- Pain relief may begin within a few days, although steroid effects can take up to two weeks to develop.
- Most people return to normal activities the next day, avoiding strenuous exercise for 24 hours.
- Your consultant may recommend physiotherapy to support longer‑term improvement.
Benefits
- May reduce mid‑back and radiating chest pain
- Can help confirm whether nerve inflammation is the source of symptoms
- May improve mobility and breathing comfort
- Minimally invasive with a short recovery period
- Can support rehabilitation and posture correction
- May reduce reliance on medication in some cases
Possible risks and side effects
Thoracic epidural injections are generally safe when performed by experienced clinicians. Possible effects include:
- Temporary increase in pain
- Mild headache
- Local bruising or soreness
- Light‑headedness
- Rarely, infection or bleeding
- Very rare nerve irritation
Your consultant will discuss individual risks and answer any concerns during your assessment.
When to consider other options
If symptoms do not improve, or if the pattern of pain suggests a different cause, your consultant may discuss:
- Thoracic nerve blocks
- Thoracic facet joint injections or ablation
- Trigger point injections for muscular tension
- Physiotherapy or posture‑based rehabilitation
- Medication review
- Combined approaches for complex thoracic pain
Safety note
Please inform your consultant if you take blood thinners, have allergies, diabetes, active infection, are pregnant, or have had previous reactions to steroid or local anaesthetic. You may need someone to drive you home depending on the medications used.
Arrange a consultation to discuss whether a thoracic epidural injection may be appropriate for you.