What is a Lumbar Epidural Steroid Injection?

Kerrie Main

Many people suffer from low back or leg pain, also known as sciatica. When pain medication treatments are not effective, they look for nonsurgical treatment alternatives. One common solution is a lumbar epidural steroid injection. An anti-inflammatory steroid medicine — usually cortisone — is injected in the lower back area, and it works to decrease inflammation and reduce pain. This type of injection might provide temporary or permanent pain relief while the damaged area is healing.

Cortisone is commonly used in a lumbar epidural steroid injection.
Cortisone is commonly used in a lumbar epidural steroid injection.

The dura membrane covers the spinal cord and nerve roots, and the space surrounding this membrane is called the epidural space. When the nerve roots are inflamed, they cause pain to shoot out from the epidural space. These types of ailments are caused by a wide variety of reasons, such as work injuries, car accidents and aging. The lumbar epidural steroid injection has been used since 1952 and plays an integral role in the overall medical treatment of back pain and sciatica. It can be effective because it delivers medication directly to the injured or pain-causing spot.

A lumbar epidural steroid injection is most frequently used in patients with sciatic nerve pain.
A lumbar epidural steroid injection is most frequently used in patients with sciatic nerve pain.

There are many steps in the administration of a lumbar epidural steroid injection. Some people require anti-anxiety or relaxation medication delivered intravenously. The lumbar area — lower back area — is sterilized with soap, then the lower back is numbed with a local anesthetic, such as lidocaine or bupivacaine. After the numbing medication has set in, the physician uses X-ray guidance to insert the injection needle into the epidural space. Many doctors inject a small amount of dye to ensure that the needle is in proper position, and then the actual steroid injection occurs.

The entire lumbar epidural steroid injection process typically takes less than 15 minutes. Patients usually are required to wait an additional 30 minutes in the recovery room to ensure that there are no complications or adverse reactions to the steroid medication. Most patients are asked to begin recording the pain relief they experience after they return home, in order to determine if the treatment worked. Some patients require three separate injections over a period of six weeks to feel actual pain relief.

There are risks associated with this pain relief treatment, such as allergic reactions to the anesthetic and steroid medications. Many people gain weight because of the large amount of steroids. Others do not feel pain relief from the series of injections and must seek alternative methods. An alternative to a lumbar epidural steroid injection is physical therapy. This type of treatment typically utilizes specific stretches and exercises to reduce or eliminate lower back pain.

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