Lumbar Epidural Injection

What is an epidural space?

It is a space that surrounds the spinal cord and nerve roots. Furthermore, the back spine is separated into four regions: cervical (neck), thoracic (mid back), lumbar (low back), and caudal (sacral area). Therefore, the lumbar epidural injection defines the epidural space in the low back region.

What are the indications of lumbar epidural injection?

Among many indications the listed are the main indications: herniated disc, degenerated disc disease (DDD), radiculopathy, bone spurs, thicken ligamentum flavum, low back fusion, failed back surgery syndrome, chronic regional pain syndrome (RSD), diabetic neuropathy and spinal stenosis.

How does lumbar epidural steroid injection bring pain relief?

The pain is produced due to inflammation of the spinal nerve roots, which may be experienced as pins/needle sensation, shooting /stabbing pain which radiate from low back down to the legs and/or feet. With the lumbar epidural injection, steroids surround the lumbar spinal nerves, which help decrease the spinal nerve root inflammation and irritation. Therefore, the lumbar epidural injection can help decrease the low back and leg pain symptoms.

What are risks for the lumbar epidural injection?

Among many, here are few listed: increased pain, infection, bleeding, nerve damage, weakness.

How is the lumbar epidural injection performed?

After sterile preparation of the lumbar region, the injection site if localized under X-ray. Following the local anesthetic applied to the injection site, which can help decrease the injection site pain, the needle is guided toward the epidural space with the help of X-ray. After the space is localized, it can be further confirmed with liquid contrast, which can help further confirm the epidural space. After the space is confirmed, the steroid medication is injected, and the needle is taken out at the end of the procedure.

What to expect after the procedure?

This is an outpatient procedure. Patients are monitored in the recovery room after the procedure. Patient is educated that pain relief may be achieved to its full potential over the 1-2 week period. Patient may experience some localized mid-back pain at the injection site, which may be minimized by the previously applied local anesthetic. Patients are discharged from the recovery room once they have the discharge criteria.

How long the relief from the lumbar epidural steroid injection would last for?

It varies from patient to patient. Usually, the pain relief can last for 6-8 weeks, and may require repeat the epidural injections if necessary. Please tell your pain physician if you are taking any blood thinners. For example: Coumadin, Plavix, Heparin, Lovenox and etc. The blood thinners need to be stopped before the epidural injection, and the time frame will be prescribed by your pain physician.
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