Lumbar epidural steroid injection

Anatomy

The lumbar spine consists of bones known as vertebrae. This spinal region is where the spinal column ends and leads into a final collection of nerve roots (cauda equina).

About

When the lumbar bones and surrounding discs, muscles, nerves, or soft tissues undergo injury or exposure to illness, they can:

• Become damaged
• Impact surrounding parts
• Result in lower back pain
• Cause bothersome and potentially life-influencing symptoms

Common causes of lower back pain

Lower back pain often results from several conditions that relate to lumbar problems, including:

• Herniated discs – Herniated discs occur when vertebrae-protecting discs develop an injury. Often this leads to pressure placed on neighboring nerves.
• Spinal stenosis – Spinal stenosis results when open spaces in the spinal region narrow. As this space decreases, pressure is placed on nerves and other nearby components.
• Degenerative disc disease – As you age, lumbar discs gradually lose protective cushioning and flexibility. This natural degradation of discs results in a higher risk of damage or even complete breakage. Illnesses like osteoarthritis could also impact disc health.
• Sciatica – Lower back pain can come from damage or weakening of the sciatic nerve. The sciatic nerve travels down your lower back to your hips, buttocks, and legs.

Risk factors

Your chances of developing one of these conditions increases if you are:

• Middle-aged or older
• Have a job requiring you to move awkwardly or place consistent and repetitive pressure on your lower back
• A participant in a sport or leisure activity where physical contact or violent movements occur
• Have to remain stationary for long periods of time

You are also at higher risk if you have arthritis or other illness impacting your bones, muscles, and soft tissues.

Symptoms

Besides lower back discomfort, lumbar spine-impacting injuries could lead to:

• Pain spreading to other regions, such as the thighs, hips, and legs
• Numbness
• Tingling
• Discomfort that worsens when making specific movements or increasing activity

In more severe instances, you might experience mobility issues.

Complications

If not properly identified and treated, you might develop potentially permanent issues like nerve damage.

Diagnosis

Your doctor will perform a physical exam and ask questions to understand your symptoms better. These may include:

• When did your pain begin?
• Where do you feel the discomfort most?
• Do any actions worsen your symptoms?
• Are you employed in a physically demanding job or participate in contact sports?

After asking these questions, your physician will check your lower back and look for noticeable abnormalities. Unfortunately, most conditions impacting the lumbar region require an X-ray or MRI.

Treatment

During this procedure, doctors administer steroids into the space surrounding your spine and surrounding nerves, known as the epidural region.

The procedure

Lumbar epidural steroid injections can be performed using one of three major approaches:

• Caudal route – Surgeons administer the injection into your lower back through the lower part of your epidural space. This is the most direct and simplest method of application.
• Transformational route – Doctors inject steroids close to irritated nerves. This technique is considered to be the most precise.
• Interlaminar route – Steroids are injected into the back of your spinal region. This method enables the medication to flow freely into the intended epidural spaces.

Intended benefits

Following the procedure, most patients experience benefits like:

• Pain reduction
• Decrease in inflammation
• Improvement in mobility
• Less reliance on over-the-counter or prescription medications

The relief from these benefits can eliminate or delay the need for more aggressive treatment like surgery.

Preparation

Surgeons caution you not to consume any food or beverages for at least eight hours before your scheduled procedure time. The injection itself is usually done in an outpatient facility. You will likely be asked to prove that you are not driving yourself home and have an alternate method of transportation before being discharged.

It is important to disclose all medications you take in advance of the procedure. This is because certain drugs might increase your risk of complications.

What to expect after lumbar epidural steroid injection

Following discharge, you are advised to return home, relax, and refrain from strenuous activities. Typically, you can return to work the next day if your job does not require heavy lifting.

If side effects occur, they are usually mild. The most common is slight soreness or discomfort at the injection site. You might find relief by using ice packs.

Outlook

You may notice pain reduction in as little as an hour or two following the shot. Pain relief is usually felt anywhere from three to five days post-injection.

Lasting pain reduction happens in approximately half of injection patients. Other factors might affect the process’s effectiveness, such as health, weight, physical fitness level, the condition causing your lower back pain, and the severity of the issue.

Injections can be re-administered on future occasions.

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