Overview
Thoracic epidural injection is a targeted treatment used when inflamed nerves in the thoracic spine contribute to persistent mid back or rib pain. The thoracic spine contains nerves that supply the mid back, ribs, and parts of the chest wall. When these nerves become irritated, symptoms may include pain, tingling, burning, numbness, or radiating discomfort around the ribs.
This irritation may develop because of disc problems, joint irritation, muscular strain, or postural overload. A thoracic epidural injection places anti inflammatory medication into the epidural space surrounding the affected nerves. The aim is to calm inflammation, reduce pain signals, and support recovery.
A thoracic epidural injection may be used for both diagnostic and therapeutic purposes depending on the clinical picture.
Who this treatment helps
Thoracic epidural injection may be considered for people with:
- Mid back pain radiating around the ribs or chest wall
- 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 arise from thoracic nerve inflammation
A consultation is required to confirm suitability and ensure the symptoms match a pattern that may respond to thoracic epidural injection.
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 using X ray guidance is commonly used to improve 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 treatment 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 around 15 to 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 while avoiding strenuous exercise for 24 hours
- Your consultant may recommend physiotherapy to support longer term improvement
Benefits
- May reduce mid back and radiating rib pain
- Can help confirm whether nerve inflammation is contributing to 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 selected cases
Possible risks and side effects
Thoracic epidural injection is generally safe when performed by experienced clinicians, but all procedures carry some risk.
- Temporary increase in pain
- Mild headache
- Local bruising or soreness
- Light headedness
- Infection, which is rare
- Bleeding, uncommon
- Very rare nerve irritation
Your consultant will discuss the possible risks, expected benefits, and any concerns during assessment.
When to consider other options
If symptoms do not improve, or if the pain pattern suggests a different cause, your consultant may discuss thoracic nerve block and PRP, thoracic facets block and ablation, trigger point injection for muscular tension, physiotherapy, posture based rehabilitation, medication review, or combined approaches for more complex thoracic pain.
Safety note
Please inform your consultant if you take blood thinning medication, have allergies, diabetes, active infection, are pregnant, or have had previous reactions to steroid or local anaesthetic. Depending on the medicines used, you may need someone to drive you home after the procedure.
Arrange a consultation to discuss whether thoracic epidural injection may be appropriate for your symptoms.
You can also explore our dorsal pain treatments, view all pain treatments, or learn more about our pain management services.