Lumbar epidurals are injections to treat and relieve low back pain. A lumbar epidural involves injecting a local anesthetic and a steroid into the epidural space of the lower spine (lower back) to reduce inflammation causing the pain.
The epidural space is the area between the dura mater (a membrane covering the spinal cord) and the vertebral wall of the spine. This contains nerves, blood vessels and soft tissues.
Indications for the Procedure
The typical indication for the procedure is low back pain that radiates down your leg, which can be caused by various medical conditions including a herniated disc or spinal stenosis.
How do you Prepare for a Lumbar Epidural?
You may be told to do the following to prepare for the procedure:
Avoid using blood thinners and aspirin before the procedure.
Stop eating or drinking for specific hours prior to the injection.
Arrange a driver to take you home after the injection.
How is the Procedure Performed?
The procedure usually takes 5-10 minutes and is performed in a surgery center, hospital, or a physician’s clinic under fluoroscopic (x-ray) guidance. You may elect to receive IV sedation for the procedure, but it is not required.
During the procedure:
You will lie on your stomach on an X-ray table.
The skin is cleaned and then numbed with a local anesthetic.
A fluoroscope (live X-ray) is used to guide a needle to the injection site.
Proper position of the needle is confirmed by injecting contrast (dye) so that it can be observed under the fluoroscope.
The steroid/local anesthetic is then injected slowly into the epidural space.
You are likely to be monitored for 20-30 minutes before being discharged.
The number of epidurals required can vary from person to person.
Risks and Side Effects Associated with Lumbar Epidurals
Risks of lumbar epidurals may include:
Increase in the pain for several days
Numbness in the legs
Puncture of dura mater leading to headache
Infection, bleeding, nerve damage
Possible steroid-related side effects are:
Facial flushing (anxiety)
Sleeplessness
High blood sugar
Cataract (decrease in vision)
Stomach ulcers
What precautions should be after the procedure?
As you recover from the procedure, you may need to:
Apply an ice pack as instructed by your doctor
Adequately rest for a specific period of time
Avoid driving or rigorous activity for at least a day
Avoid taking a bath or using a hot tub for 24 hours
Benefits of Lumbar Epidural Injections?
Lumbar epidurals are safe, effective and help to:
Control inflammation
Relieve pain
Minimize the use of pain medicines
Delay or avoid surgery
Boost mental health
Improve the quality of life
How long does an epidural steroid injection last?
This is a common question with no simple answer. It depends on multiple factors including the severity of the problem that is being treated. Every patient is different. Some patients experience long-term relief of the pain and do not need a repeat injection. Other patients may receive partial relief of the pain and need a second or third injection. In general, we consider it a successful injection if you experience over 50% relief of pain for at least 3 months.
