The anti-inflammatory properties of injectable corticosteroids are commonly used to treat a variety of chronic pain conditions. The primary role for the injection of corticosteroids is to reduce inflammation and pain through the localized delivery of the medication to target tissue in efforts to maximize benefit and limit systemic side effects. Spinal injections, such as epidural steroid injections (ESI), facet joint injections, and sacroiliac injections, are frequently utilized interventions to treat spine and radicular pain, while joint, muscle, and tendon sheath injections are commonly used for a variety of musculoskeletal pain conditions. Peripheral nerve blocks, utilized for perioperative anesthesia and analgesia, may include a corticosteroid component for the enhancement of neural blockade and analgesia. The appropriate utilization of injectable corticosteroids takes into consideration the aspects of safety according to site and contents of injection, as well as potential associated systemic consequences. This chapter reviews the unique set of properties of the most commonly utilized injectable corticosteroids and highlights key aspects of their use in epidural and musculoskeletal injections.
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