A Lumbar Epidural Steroid Injection is a Pain Management procedure used for treating many forms of low back pain and leg pain caused by conditions such as sciatica. The procedure provides pain relief by reducing the inflammation and swelling of the nerve roots as they exit your spine.
The nerve roots that leave your spine in the lower back area serve your legs. If you injure a lumbar nerve root, you may feel pain, weakness, numbness or tingling in your leg.
A Lumbar Epidural Steroid Injection deposits local anesthetic and steroid medication into the epidural space of your spine, right at the injured lumbar nerve root. The epidural space is located just outside of the protective sac containing your spinal fluid.
Your back doctor performs this procedure to relieve your low back and/or radiating leg pain. Steroid medication can reduce the swelling and inflammation caused by certain spinal conditions. The procedure is described below. Consult your back doctor about your risks and what to expect after the procedure.
1. Locating the Epidural Space
You must lie face down on an X-ray table. A cushion under your stomach provides comfort and flexes your back. In this position, your spine opens, providing your doctor easier access to the epidural space. To numb the skin over your spine, the doctor applies a local anesthetic. A fluoroscope guides the needle as the physician locates the appropriate lumbar vertebra and nerve root. Refer to the top illustration.
2. Anesthetizing the Tissue
Once he’s found the correct lumbar vertebra and nerve root, the doctor anesthetizes all the tissue above it, from just beneath the skin down to the surface of the vertebra’s lamina, which is the back portion of the vertebral bone.
3. Guiding the Needle to the Epidural Space
Your physician slides a thicker needle through the anesthetized track down to the lamina. Using the fluoroscope for guidance, he slides the needle toward the epidural space between the L-4 and L-5 vertebra.
4. Injecting the Contrast Dye
The doctor injects a contrast solution, as shown in the middle illustration. The fluoroscope shows the painful areas as the doctor confirms the correct location of the needle’s tip.
5. Injecting the Steroid Medication
As shown in the bottom photo, your back doctor then injects a steroid/anesthetic mix into the epidural space, bathing the painful nerve root with soothing medication.
6. Recovering from the Procedure
Once the needle is removed, the physician applies a small bandage to the tiny needle surface wound. In some cases, it may be necessary to repeat the procedure as many as three times to get the full benefit of the medication. You may receive significant pain relief from only one or two injections.
For information about the safety of the treatments at the Southeastern Spine Institute (SSI), refer to the Spinal Injections Safety report.
For more information about nerve blocks and epidurals, refer to SSI’s Block Suite.
Find out more about SSI’s Pain Management procedures.