Lumbar Epidural Steroid Injections

Your physician may refer you for a procedure called a Lumbar Epidural Steroid Injection. This procedure is used to treat swollen and inflamed spinal nerve roots often referred to as a "pinched nerve," which may cause low back and leg pain. The spinal nerves come from the spinal cord and exit the backbone to go to the lower part of your body and the legs. Occasionally something rubs or irritates these nerves where they exit the backbone causing them to be swollen and inflamed. The source of irritation may be a ruptured, herniated, or bulging disc.

Another source may be Spinal Stenosis, where arthritis of the spine, bone growth, or hardening of the ligaments begins to close the openings in the spine through which these nerves exit. The symptoms are as follows:

  • Pain in the lower back
  • Pain down one or both legs
  • Numbness or tingling of your legs or feet
  • Weakness in one or both legs or feet

This technique involves an injection of a steroid into an area of your lower back called the epidural space. The epidural space extends through the spinal canal from your head to your tailbone. The spinal nerves pass through the epidural space and are therefore bathed in this steroid (a solution of anti-inflammatory medicine). Within a few days after the injection, the medicine should reduce the swelling and inflammation of these nerves and thereby offer pain relief.

The procedure is done under intravenous sedation using fluoroscopy (x-ray) as a guide. The doctor takes x-rays during the injection and watches the pictures on a television screen. It is a x-ray guided procedure. After the injections you would stay in the recovery room for about 30 minutes to 1 hour, then you can go home.

You will probably be asked to return two weeks after your first injection. If all of your pain or numbness has been relieved, you will not need another shot at that time. Most often, however, the first injection will relieve some, but not all of your pain or numbness. At that time (2 weeks after the first injection) we will suggest a second epidural steroid injection. Occasionally you may require a third injection two weeks after the second one. After a series of three injections, a maximal effect is reached.