Lumbar Epidurals

What is a lumbar epidural?

Lumbar epidural steroid injections, also known as LESIs, are used to treat pain in the legs and lower back, and are often involved in the long-term treatment for conditions such as sciatica. For some patients, a lumbar epidural steroid injection is enough for complete relief; for others, LESIs are paired with a rehabilitation program.

The LESI is shot in the back, sending steroids straight into the epidural space around the patient’s spine, which contains the cerebrospinal fluid, nerve roots, and spinal cord. The steroids are sometimes coupled with an anesthetic or saline solution, to help wash away any inflammatory mediators that might be adding to the pain.

The relief brought on by a lumbar epidural injection varies patient by patient, with reported relief lasting anywhere from a week to an entire year. These injections can be nearly crucial for times when lower back or leg pain becomes too intense, allowing the patient to escape the pain and continue with their rehabilitation (generally involving exercise and stretching).

When would I need a lumbar epidural injection?

There are a variety of conditions that can bring about chronic lower back or leg pain caused by irritation to the nerves. Lumbar epidural steroid injections can help the following conditions:

Annular tear
Cysts
Lumbar spinal stenosis
Lumbar disc herniation
Compression fractures
Degenerative disc disease
If you are looking to avoid surgery, a LESI might be your best option. However, it is highly recommended that you do NOT take a LESI if you have one of the following conditions:

Bleeding problems (including having a history of using blood thinners)
Pregnancy
Systemic or local infection
If your pain might be caused by a spinal tumor
Before the Procedure

Prior to the procedure, it is important that your doctor is aware of any medications you might be taking, especially aspirin and blood thinning drugs like Plavix and Ticlid (as these may cause bleeding during the procedure). Your doctor will advise you to stop taking these medications for a few days before your procedure.

Other issues which your doctor must be aware of that might cause problems for your procedure include any allergies and other medical problems you are currently dealing with, such as diabetes and renal disease.