Lumbar Epidural Steroid Injection

A lumbar epidural steroid injection is administered to reduce pain in the lumbar spine, also known as the low back. This type of injection is not a cure, but rather a treatment, and can temporarily alleviate discomfort in the area extending from the lower spine to the hips and possibly even down the leg.

Patients who have not already found significant relief from low back pain with non-invasive therapies such as medications or physical therapy are good candidates to benefit from a lumbar epidural steroid injection.

The injection, which usually consists of a corticosteroid and a local anesthetic, is administered in the outer part of the spinal canal, also called the epidural space. The pain specialist will make the injection as close to the affected nerves as possible to reduce inflammation and pain for the patient.

To administer the lumbar epidural steroid injection as precisely as possible, the doctor will order an MRI scan of the patient’s back. By studying this, he or she will be able to determine exactly where the problems are located, as well as the injection site that will deliver the patient the greatest amount of pain relief.

Prior to the procedure patients are also recommended to stop taking medications that prevent clotting, such as aspirin, ibuprofen, naproxen and others. This is to limit the possibility of excessive bleeding at the injection site.

For the procedure, which typically lasts about 15 to 20 minutes, the doctor will ask the patient to lie face-down on an elevated table. After sterilizing the patient’s back, the doctor will then guide the needle into the epidural space using X-ray guidance for the most precision. When the needle is in the correct position, the doctor will release the medications. The patient may feel some pressure during the positioning of the needle and the injection.

Immediately following the injection a patient may feel some pain resulting from the injection itself, or his or her symptoms might temporarily become worse. The effects of the corticosteroid develop gradually over a period of a few days, and then a patient can typically expect the pain relief to last for several weeks to several months.

All procedures carry some risk, although the risks associated with lumbar epidural steroid injections are relatively few and most are not serious. Potential complications and negative side effects a patient may experience with this type of injection include nerve damage, nausea, allergic reaction, excessive bleeding or infection at or around the injection site, and internal bleeding.

Because lumbar epidural steroid injections affect bone health, muscle strength, and hormonal balances, it’s usually not recommended that lumbar epidural steroid injections are administered with frequency, or over a long period of time. Doctors usually limit their patients to two or three injections per year and do not increase a patient’s dosage unless absolutely necessary.

However, for those patients who have exhausted other forms of therapy without the results they want, the injections can provide some relief.

• www.nlm.nih.gov/medlineplus/ency/article/007485.htm