Lumbar Epidural Steroid Injection, Southlake, TX is a minimally invasive procedure to help relieve lower back and leg pain. The injection is given in the lumbar epidural space to help reduce inflammation and pain caused by inflamed spinal nerves that may be due to herniated disc, spinal stenosis, degenerative disc, or any other causes.
The epidural space is the area between the bony vertebra and the protective sac of your spinal nerves that are filled with fat. The epidural space provides cushioning for the nerves and the spinal cord.
Lumbar epidural steroid injection involves injecting corticosteroids and anesthetic numbing agents into the epidural space of the spine to reduce inflammation and relief the pain. The injection works on the spinal nerves by flushing out the protein that is causing inflammation.
What leads to pain in the lumbar epidural region?
Narrowing of the spinal canal may cause the spinal nerves to become inflamed. Narrowing of the spinal canal may be caused by spinal stenosis, bone spurs, herniated disc, joint cysts, thickening of the ligaments, or abnormal alignments of the vertebral column.
Who is an ideal candidate for this procedure?
Patients who are experiencing chronic pains at their lumbar back area are generally ideal candidates for this procedure. Patients with any of these conditions below may be ideal candidates for this procedure:
Herniated disc, also known as a ruptured disc can occur and cause chemicals to leak out of the disc. The chemicals can irritate the nearby nerve roots and lead to inflammation, pain, and numbness.
This is the narrowing of the spinal canal and nerve root canal which can lead to lower back pain and leg pain.
Degenerative disc occurs due to the aging of the intervertebral disc. This can lead to breakdown or collapse of the disc space, growth of bone spurs or tears in the annulus.
The weakness or fracture between the upper facets and the lower facets of the vertebra is known as spondylolisthesis. This may cause the vertebra to slip forward and compress the nerve roots leading to pain.
This is mostly caused by the compression of the lumbar nerve.
Patients with bleeding problems, infections, diabetes may not be ideal candidates for the procedure. Pregnant women may also not be ideal candidates. Speak with your doctor first if you are pregnant before undergoing the procedure
Before the procedure
Before undergoing the procedure, your medical history and previous imaging tests will first be reviewed by your doctor to determine the best approach for the treatment.
You may have to avoid blood-thinning medications for several days before the injection. Inform your doctor if you are currently on any medications. Also, inform your doctor if you have any allergies to prevent adverse side effects.
How is the procedure done?
During the procedure, you will be asked to lie down on your stomach on a procedure table. Your doctor will apply a local anesthetic to numb the area where the injection will be given. The local anesthetic is to reduce discomfort and pain not to make you unconscious or sleep. You are meant to stay conscious so that you can inform the doctor of any changes you feel.
With the aid of a fluoroscope, your doctor will then inserts a needle into the epidural space. Your doctor uses the fluoroscope to see through your skin in order to know if the needle is in the right position. A contrast dye is then injected into the area so that your doctor can see the position of the needle more clearly.
When the needle is placed in the right position, corticosteroid medication is injected into the area to reduce the inflammation and an anesthetic agent such as lidocaine or bupivacaine is also applied to relieve the pain.
The corticosteroids and anesthetic agent injected will spread over several spinal segments and cover both sides of the spinal canal.
After the medication has been injected, your doctor will then slowly remove the needle and clean up the skin around the injection site.
It usually takes between 20-40 minutes for the procedure to be completed.
After the procedure
After the procedure is completed, you will be taken to a recovery room and monitored for about 30 minutes. You may feel some soreness or irritation at the injection site for a few minutes or hours. You can apply ice packs for about 20 minutes to relieve the pain.
Your doctor will provide instructions that you need to follow. You may also be given a pain diary to record the pain level and your recovery process daily.
You may be asked not to drive for 12 hours after the injection. You will need to avoid heat to the injection site for at least 72 hours.
You may restart your regular medications including pain medications and blood thinners.
You can go back home after the procedure but you need to ask someone to drive you home.
Inform your doctor if you experience any adverse side effects or if you feel continuous increased pain.
Results of the procedure
Many patients experience immediate pain relief from the anesthetic agent. This will wear off after some hours. The corticosteroid will usually start to work within 1–3 days. Some patients may experience an increase in pain when the numbing agent wears off before the corticosteroids start to take effect. The effect of the corticosteroids lasts much longer.
The duration of the pain relief varies depending on the severity of the nerve damage and individual patients. You may experience pain relief for several weeks to years.
Potential risks and complications that could occur
Lumbar Epidural Steroid Injection, Southlake, TX this procedure is generally a safe procedure, however, some patients might experience some side effects such as:
- Steroid flush
- Inability to sleep well
- Changes in the menstrual cycle
- Elevated blood such in diabetic patients
- Mood swings
- Water retention
- Weight gain
- Numbness or mild muscle weakness
- Allergic reaction
- Rare cases of nerve damage or paralysis