A lumbar epidural steroid injection can be used both therapeutically to treat the cause of back pain, and also may be used diagnostically to determine where pain originates.
The lumbar nerves travel from the back into the buttocks and legs, which is why pressure on these nerves often results in leg pain. The most common causes for pressure on this nerve and the resulting pain is disc degeneration, herniated discs, and spinal stenosis, a condition in which the open space of the spine narrows, placing pressure on the spinal cord and nerve roots that travel through the spine.
Lumbar epidural steroid injections consist of both a local, temporary anesthetic and a longer-lasting steroid, the combination of which “turns off” the nerve for a short period of time, granting relief from pain and the ability to determine exactly where pain is originating from.
The patient will lie on their stomach, either completely flat or with a small pillow under the abdomen to create a gentle curve to the back. If this position is impossible, the Tulsa Pain team may have the patient lie on their side.
The skin of the low back will be cleaned, and then a local anesthetic will be injected to numb the area to reduce pain felt during the procedure. Using a live form of x-ray called fluoroscopy, the physician will guide the needle toward the correct position in the epidural space. Fluoroscopy is used to pinpoint the exact location where the medication should be injected to reduce the chance of error.
Once the correct position has been determined, the injection will be administered. This should not be painful, but a sensation of pressure may occur, depending on how much medication is injected. The physician will remove the needle, and may place a small bandage over the injection site. Patients are usually monitored during a brief recovery period and then sent home the same day.
Patients are generally advised to rest following the injection, and may use ice at the injection site if tenderness is experienced. Patients are usually able to resume normal activity the next day unless otherwise directed by their physician.
If used therapeutically, patients will usually experience pain relief for several months to a year. Injections may be repeated both for increased efficacy or if the steroid begins to wear off. If lumbar epidural steroid injections were used diagnostically, the next step will be for your pain specialist at Tulsa Pain to discuss further treatment options.
