Lumbar epidural injections are commonly given to patients suffering from chronic low back pain caused by nerve irritation and inflammation. This type of severe pain may be related to various conditions like fractures, ruptured intervertebral discs, arthritis, and spinal stenosis. These conditions may cause pinching, compression and irritation of spinal nerves and lead to symptoms like low back pain, which can radiate to the buttocks and legs. One may also experience muscle stiffness, tingling or numbing and weakness in the legs. When these symptoms do not respond to conservative treatments, a lumbar epidural may be a suitable option. In addition, patients who experience cancer-related pain may also benefit from this form of treatment.
How a Lumbar Epidural Works
The goal of lumbar epidural injection is to reduce chronic pain and inflammation in the lumbar area, buttocks, and legs. This treatment consists of short outpatient procedures that are done either in the hospital or in a doctor’s clinic.
An anti-inflammatory medication consisting of local anesthetics and steroids is injected into the spinal area of the lower back below the waist, to bathe the affected nerves and discs. Since the treatment uses locally administered medications, it does not have a widespread effect on the body; rather, only painful areas are targeted, and no systemic side effects are expected.
Patients benefit from this procedure because after the injection, inflammation and pain are reduced for several months, allowing the patient to resume normal activities and undergo rehabilitation or physical therapy while healing takes place.
A lumbar epidural is a procedure performed by a qualified Chronic Pain Specialist who is an expert with the treatment. After thorough evaluation, the patient is briefed about the procedure and prepared beforehand so that he is relaxed. He may be given an oral medication to relax.
The patient is positioned sitting up or lying on the stomach. The skin at the lumbar area is cleansed thoroughly with sterile scrub. A small amount of local anesthesia is administered on the skin and underlying tissues to numb the area before treatment.
When ready, the physician directs a special needle with x-ray guidance into the lumbar epidural space, which surrounds the outer covering of the spinal cord. Proper positioning of the needle is ensured with the use of a small amount of contrast medium or dye injected before the medication is given.
Finally, a small mixture of local anesthetic and anti-inflammatory (steroid) drug is injected into the epidural space. The patient may experience temporary discomfort, numbing, and weakness of the back and legs for a few hours, which is an expected result.
The patient is monitored for about an hour before they are discharged. They will be asked to evaluate their improvement in the succeeding week and report for follow-up. Repeat injections may be performed up to three times, if needed, every two weeks.
A lumbar epidural injection is a minimally invasive, safe, and effective means of treating low back pain that is unresponsive to other forms of treatment. If you want more information about treating chronic low back pain, contact our Pain Management Specialist who will examine you and conduct tests to determine the cause of your back pain. Make an appointment with the NYC’s top board-certified interventional pain management physician to know if lumbar epidural injections are a treatment option for you.