An epidural steroid injection is an advanced interventional technique where local anesthetic and steroid medications are deposited in the epidural space with the intention of reducing low back and leg symptoms. When the nerve roots are compressed or displaced, they become inflamed, swollen and irritated. This often leads to symptoms in the low back and legs including pain, achiness, numbness, tingling, burning and weakness. By bathing these irritated nerve roots in steroid, we aim to reduce the inflammation, thus reducing these symptoms. These procedures can be done in the cervical, thoracic, lumbar and sacral spines.
Epidural steroid injections are performed by licensed interventional pain physicians using fluoroscopy (X-Ray). Under fluoroscopic guidance, a special needle is placed into the back, through the skin and subcutaneous tissues, between the vertebrae and into the spinal canal. The goal is to position the needle tip into the epidural space, which is inside the spinal canal, but outside of the dural sac which contains the spinal cord and cerebral spinal fluid. Once the desired epidural needle position is achieved, placement is confirmed with a small amount of contrast dye and the local anesthetic and steroid medications are injected into the epidural space.
After an epidural steroid injection, patients typically start to feel pain relief within 3-5 days and that pain relief generally continues to improve over 2-3 weeks. Epidural steroid injections can help reduce pain for anywhere from 3-9 months. These injections can be repeated as needed.
Indications:
An epidural steroid injection can be helpful in treating the following conditions:
- Spinal stenosis (central, foraminal or lateral recess stenosis)
- Disc herniation
- Radiating pain into the buttocks and down the legs like “sciatica”
- Disc herniation
- Degenerative Disc Disease
- Nerve root compression
- Compression fractures
- Postherpetic neuralgia
- Low back pain
- Post Laminectomy pain
Side Effects: Steroid can sometimes cause facial flushing/warmth, increased energy, elevated heart rate and difficulty sleeping for 1-3 nights after the injection. Severe side effects are rare.
Risks/Complications: When done appropriately, there are few risks associated with epidural steroid injections. Sterile technique is utilized to minimize the risk of infection. In addition, patients need to be off blood thinning medications to reduce the risk of epidural hematoma. These are safe procedures and permanent nerve damage is very rare.
