Lumbar Epidural Steroid Injection
A lumbar epidural steroid injection is a minimally invasive procedure for treating leg, buttock and lower back pain originating from the epidural space. The epidural space surrounds the dura, a membrane which protects the spinal cord and its nerves. The primary reasons for pain in this area are herniated or ruptured discs, stenosis, or sciatica all of which result in nerve compression. The pain may originate in any part of the lumbar region of the spine, including the coccyx, or tailbone, where it is referred to as caudal.
A lumbar epidural steroid injection is usually administered in an outpatient surgical setting under local anesthetic. After the local anesthetic has numbed the skin, a small needle is inserted into the epidural space with the assistance of an imaging technique known as fluoroscopy. Once the targeted area is pinpointed, the medications, which include an anesthetic and a corticosteroid, are injected.
After a lumbar epidural steroid injection, most patients return to work the next day. They normally experience immediate pain relief for a few hours after the procedure as a result of the injected anesthetic, although there may be some irritation at the injection site. In a few days, the original pain may worsen again as the anesthetic wears off. This is completely normal. In about a week, the corticosteroids will take full effect, reducing inflammation and significantly reducing pain. Depending on the patient's response, the doctor may administer as many as three epidural injections spaced several weeks apart.
The effectiveness of a lumbar epidural steroid injection varies. Some patients experience long-term, or sometimes even permanent, pain relief after one injection, requiring no further treatment. Others may require additional treatment a few weeks or months later. The exact effectiveness of a lumbar caudal epidural steroid injection depends on the individual patient's condition.