Practice of epidural steroid injections outside of the United States

Spinal pain syndromes are major causes of morbidity and disability globally. Epidural steroid injections (ESIs) play a vital role in the nonsurgical management of radiculopathy pain. These are simple, cost-effective, minimally invasive, percutaneous interventions routinely performed by a Pain physician. ESIs can be a diagnostic tool in patients where clinical, radiological, and electrophysiological criteria do not clearly establish a causal relationship. Use of image guidance and transforaminal approach are found to be more efficacious in comparison to the conventional blind and interlaminar approach. The rationale behind ESIs is to deliver focused high concentration of the drug close to the inflamed nerve root, making it more effective than when given by oral or intramuscular route. The main objective of this article is to evaluate and analyze the current practice trends for ESIs in different geographic locations of the world outside of the USA. It may be interesting to compare it with the practice in the USA to find similarities and differences.