The Lowdown on Lumbar Epidural Steroid Injections

Lumbar epidural steroid injections (LESIs) are a minimally invasive treatment option for individuals experiencing lower back pain. These injections involve the delivery of a corticosteroid medication into the epidural space of the lumbar region of the spine. The epidural space is the area surrounding the spinal cord and nerve roots. LESIs can be performed through two different techniques: transforaminal or interlaminar injections.

What are the indications for LESIs?
LESIs are commonly used to alleviate pain caused by inflammation in the lower back, often resulting from conditions such as herniated discs, spinal stenosis, and degenerative disc disease. LESIs can help reduce pain, inflammation, and swelling, and improve mobility in individuals experiencing these conditions.

What are the benefits of LESIs?
LESIs are generally considered safe and effective. They can provide pain relief for up to several months and allow individuals to engage in physical therapy or other forms of rehabilitation without being hindered by pain. LESIs may also help individuals avoid surgery, reduce the need for pain medications, and improve overall quality of life.

What are the risks associated with LESIs?
While LESIs are generally safe, there are some potential risks associated with the procedure. These include infection, nerve damage, bleeding, and allergic reactions to the medication. There is also a small risk of developing spinal cord damage, although this is extremely rare. It is important to discuss potential risks with a healthcare provider before undergoing LESIs.

What is the difference between Transforaminal vs. Interlaminar LESIs?
Transforaminal LESIs involve the injection of medication into the spinal nerve root as it exits the spinal canal. Interlaminar LESIs, on the other hand, involve the injection of medication into the epidural space between the vertebrae. Transforaminal injections are more targeted and may be preferred for certain conditions, while interlaminar injections are more commonly used for general pain relief.

What are the alternative treatment options to LESIs?
LESIs are just one option for managing lower back pain. Other treatment options include exercises, physical therapy, chiropractic care, medication, and surgery. The most appropriate treatment option will depend on the individual’s specific condition and medical history.

What to expect during and after LESIs?
LESIs are typically performed on an outpatient basis under local anesthesia. For those in severe pain and/or with significant phobias of needles, sedation might be an option. During the procedure, the individual will be positioned on their stomach or side, and a small needle will be inserted into the epidural space. A contrast dye may be used to ensure proper placement of the needle, and the medication will then be injected. After the procedure, the individual will be monitored for a short period of time and will be able to go home the same day. It is important to rest for a day or two after the injection and avoid heavy lifting or strenuous activity for several days.

How long to feel relief and how long will it last?
Relief from LESIs can vary from individual to individual. Some individuals may experience immediate relief, while others may require several days to feel the effects of the injection. Relief can last anywhere from a few weeks to several months, depending on the individual’s condition and response to the injection.