LUMBAR EPIDURAL STEROID INJECTION
LOWER BACK PAIN DOCTOR
Back Pain Relief
The Pain Relief Center in Plano, Texas offers Lumbar Epidural Steroid Injections for lower back pain relief. Call us today for more information or to schedule an appointment.
What is it?
A lumbar epidural steroid injection (LESI) delivers a steroid medication directly to the spinal nerve roots that reside in the lumbar (lower back) region, in order to provide relief from pain in the area. There are multiple causes that can potentially lead to lumbar or low back pain. These include:
Herniated or bulging disc: A herniated or bulging disc usually refers to a problem, such as the dislodgement of a disc, with the rubbery cushions between the vertebrae in the spine. It can irritate nearby nerves and cause pain, numbness or weakness in the back, arms or legs.
Osteoarthritic bone spurs: Bone spurs are bony projections that develop along the edges of bones, and often form where bones meet each other in the joints. The main cause of these are associated with osteoarthritis.
Lumbar spinal stenosis: As we age, degeneration of the vertebrae, discs, muscles, and ligaments in the spine can occur as a result of spinal changes. These changes can lead to spinal stenosis, which means that the spinal nerves in the lower back are essentially “choked,” and most often leads to leg pain and other symptoms.
Degenerative disc disease: Degenerative disc disease is more of a description of the changes in the spinal discs that occur as we age, rather than an actual “disease.” As these changes occur in the discs in the lower back and neck, osteoarthritis, herniated discs and spinal stenosis can occur and cause pain in these areas.
Synovial cyst in the lumbar spine: A synovial cyst is a fluid-filled sac that develops as a result of degeneration in the spine. Because it develops from degeneration, it is not often seen in patients younger than 45, and is more common in patients older than 65.
Annular disc tear: A rupture or opening in the annulus fibrosus (the tough outer layer of the discs between the vertebrae). When the gel-like substance inside the disc leaks out, it can come in contact with spinal nerves and trigger pain.
Any condition or injury that causes nerve root irritation, inflammation or damage can lead to lower back pain that has radiated from lumbar nerve roots. A common occurrence of radiated pain from general compression or irritation is known as sciatica. The sciatic nerve is the longest and largest spinal nerve in the human body, and it originates from the lower spine and extends all the way down the back of the legs to the toes, delivering nerve signals to the muscles and skin along the way. If this nerve becomes injured or irritated and any point, the pain symptoms can travel from the lower back, through the pelvic area, and down each leg.
How is it done?
The procedure is very similar to the lumbar sympathetic block, as it is done with the patient lying on stomach. The patients are monitored with EKG, blood pressure cuff and an oxygen-monitoring device. Temperature sensing probes may also be placed on your feet. The lumbar sympathetic block is performed under sterile conditions. The skin on back is cleaned with antiseptic solution and the skin is then numbed with a local anesthetic. Then X-ray is used to guide the needle or needles into the proper position along the outside of the spine. Once in place, a test dose of dye is used to confirm that the injected medication will spread in an appropriate area. If this is okay, the injection takes place gradually over several minutes. The physician will use the X-ray to evaluate the spread of the injected medication. When a sufficient area is covered, the injection will be over. When done, the needle is removed and a Band-Aid is applied.
There are multiple approaches to reach the lumbar epidural space. The three most commonly used methods for the application of epidural steroids include Interlaminar, Transforaminal, and Caudal. The interlaminar approach is the most common method for epidural injections, however, all three approaches involve the placement of a thin needle utilizing fluoroscopy.
What should I expect?
The local anesthetic wears off in a few hours. However, the blockade of sympathetic nerves may last for many more hours. Usually, the duration of relief gets longer after each injection. Unless there are complications, you should be able to return to your work the next day. The most common thing you may feel is soreness in the back at the injection site.
How long will it take?
The actual injection takes between 10 and 30 minutes, but there will be an additional period of time where the doctor will want to keep the patient for observation before discharging them to go home. Physical therapy may be recommended, or simple home exercises to keep the area from stiffening up.