What is a lumbar epidural steroid injection?

An anti-inflammatory medicine — a steroid or corticosteroid — into the epidural space around the spinal nerves in your low back. Lumbar epidural steroid injections help to manage chronic pain caused by irritation and inflammation of the spinal nerve roots in the lumbar region of your spine due to certain conditions or injuries.

The steroidal medication injected into a painful joint space can help soothe the pain. Injecting corticosteroids into the joint will not provide permanent relief on its own,  however, it can dramatically reduce inflammation and pain. The effects can last anywhere between 1 week to 1 year. Injections for joint pain are usually one of the steps taken before resorting to surgery. In some patients, steroid injections can reduce pain to the point where patients are able to participate in Physical Therapy, which in turn can strengthen the surrounding muscles and eliminate the need for further treatment.

This procedure takes about 15-30 minutes. The patient typically will not feel any pain during the procedure as local anesthesia will often be injected near the epidural site. Some doctors will often give patients anti-anxiety medication and narcotic analgesics such as fentanyl to both help relax the patient and help the anesthetic (numbing medication) work better.

What do lumbar epidural steroid injections help treat?

• Lower back pain
• Herniated Disc
• Rheumatoid Arthritis
• Scaitia
• Spinal stenosis
• Degenerative disc disease
• Spondylolysis

What are some of the benefits of a lumbar epidural steroid injection?

• Reduce nerve pain and inflammation
• Decrease oral medication intake
• Continue or begin physical activity
• Postpone Surgery
• Improve mobility

How soon does a lumbar epidural steroid injection work after the inital procedure?

The first two or three days after the injection may feel more painful before it begins to improve. Epidural steroid injections start working within two to seven days. The pain relief can last from one week to several months, however, some patients may find more permanent relief. 

What are some of the side effects of lumbar epidural steroid injections?

• You may experience a temporary increase in pain before the steroid medication starts working.
• You may have tenderness and/or bruising at the site of your injection.
• Fluoroscopy may be used for imaging guidance. With fluoroscopy X-rays, there will be minimal low-level radiation exposure; Because of this, informing your healthcare provider if you’re pregnant or might be pregnant is extremely important. Fluoroscopy X-rays can be harmful to the baby.
• An epidural steroid injection will likely cause high blood pressure (hyperglycemia) in patients with diabetes. High blood pressure could last for hours and/or days.
• Increased blood pressure and eye pressure may be common after lumbar epidural steroid injection in patients with glaucoma.

What are the risks and complications of a lumbar epidural steroid injection?

Although rare, risks and complications that apply include:

• Lightheadedness due to low blood pressure.
• Severe headache caused by spinal fluid leakage.
• Infections such as an epidural abscess, discitis, osteromyelitis or meningitis.
• Negative reaction(s) to the medications, such as hot flashes or a rash.
• Bleeding from accidental blood vessel damage during the injection, which could lead to a hematoma or a blood clot formation.
• Nerve damage at the injection site.
• Temporarily losing control of your bladder and bowels. A catheter may need to be inserted in your bladder to help you pee.

If you believe that a lumbar epidural steroid injection could improve your quality of life and help manage your pain, contact us. Our doctors will determine how Nextgen Wellness can best treat your condition.