Lumbar Epidural Steroid Injection
Lumbar epidural steroid injections deliver corticosteroid medication into the epidural space surrounding the spinal cord to reduce inflammation around compressed or irritated nerve roots. This can provide significant pain relief and serve as a bridge to rehabilitation.
What Is It & Who May Benefit?
Lumbar epidural steroid injections deliver corticosteroid medication into the epidural space surrounding the spinal cord to reduce inflammation around compressed or irritated nerve roots. This can provide significant pain relief and serve as a bridge to rehabilitation.
Symptoms
- Sciatica from lumbar disc herniation
- Lumbar spinal stenosis
- Lumbar radiculopathy
- Post-surgical recurrent radiculopathy
- Failed back surgery syndrome
How It's Performed
Patient positioned prone on fluoroscopy table
Fluoroscopic guidance confirms target level and trajectory
Sterile preparation and local anesthesia
Tuohy needle advanced to epidural space using loss-of-resistance technique
Contrast confirms epidural spread
Mixture of corticosteroid and local anesthetic injected
Three approaches: interlaminar, transforaminal, caudal
Risks & Complications
- Post-procedure headache (dural puncture, ~1-2%)
- Infection (<1%)
- Bleeding
- Temporary increase in pain
- Systemic steroid effects (rare with single injections)
- Allergic reaction to injectate
Benefits
- Rapid reduction of nerve root inflammation
- Pain relief enabling participation in physical therapy
- Avoidance or delay of surgery in many cases
- Minimal systemic steroid exposure with single injections
- Repeatable as needed
Recovery
Related Conditions
Sciatica
Sciatica refers to pain that radiates along the path of the sciatic nerve, from the lower back through the hips and buttocks and down the leg. It typically affects one side of the body and is caused by compression of the sciatic nerve roots (L4-S3), most commonly from a lumbar disc herniation or foraminal stenosis.
Lumbar Spinal Stenosis
Lumbar spinal stenosis (LSS) is a narrowing of the spinal canal, lateral recesses, or neural foramina in the lumbar spine that results in compression of neural structures. It is the most common reason for spinal surgery in adults over 65 and is typically caused by degenerative changes including disc bulging, facet joint hypertrophy, and ligamentum flavum thickening.
You May Also Want to Understand
Is This Procedure Right for You?
A thorough clinical evaluation is essential to determine whether lumbar epidural steroid injection is appropriate for your specific condition.
Dr. Shahnawaz F Shah