Epidural steroid injections are beneficial in treating pain caused by inflamed or compressed nerve roots. Also called radiculopathy, nerve root pain occurs when the nerves that leave the spine are pinched or irritated. The affected nerve innervates areas of the back and legs also known as dermatomes. Pain in these specific areas allows the doctor to expertly determine where to place the epidural injection. Epidural injections can be helpful in treating the following conditions:
The lumbar epidural steroid injection is comprised of both a local anesthetic and a steroid medication and can be used for both diagnostic and therapeutic purposes. The anesthetic medication alleviates nerve pain rapidly while the steroid medicine reduces inflammation and can provide long lasting relief. The steroid medication can take 2-3 days up to a week to fully work. Contrast dye is used to ensure the medication is correctly administered into the epidural space.
Blood thinning medications must be held prior to the injection as directed by your doctor. You must bring a driver with you to the appointment.
Epidural injections can be performed with either an interlaminar approach or a transforaminal approach. With the interlaminar approach, the procedure takes place in the middle of the back. The needle is inserted between the lamina of two vertebrae on the backside of the spine. The medication is injected into the epidural space and flows to the nerves on both sides. With the transforaminal approach, the needle is inserted to the side of the vertebra where the nerve roots exit. The allows specific nerves to be targeted and is used to treat both unilateral and bilateral pain in the legs.
The side effects are similar to that of all procedures and include: bleeding, infection, and nerve damage. The chance of this happening is very rare as the doctor uses both a c-arm fluoroscope machine to guide him and contrast dye to ensure he is in the correct location. Potential side effects to the steroid medication include high blood sugar, facial flushing, and difficulty falling asleep. This only lasts about a day.
Reduce procedural discomfort by applying ice for 15-20 minutes every 2-3 hours to reduce injection site swelling and irritation. NSAIDs and/or Tylenol are also recommended.