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Lumbar Epidural Injection 101

Date: February 3, 2022

Spine and pain management professionals such as physiatrists, anesthesiologists, radiologists, neurologists, and spine surgeons perform this sort of injection.

Typically, the injection treatment is performed in a surgery center, hospital, or physician's office.

What is Lumbar Epidural?

A spinal epidural injection delivers anti-inflammatory medication directly into a targeted area of the spine's epidural space. The medicine aids in reducing nerve root inflammation, which should alleviate back or leg discomfort.

By decreasing inflammation, the epidural injection may help in the healing process. It may give lasting relief or provide many months of pain relief while the injury or cause of pain heals.

What Conditions Can Lumbar Epidural Injection Treat?

Typically, lumbar epidural injections treat disorders that cause irritation and inflammation of spinal nerve roots, accompanied by lower back and leg discomfort. In contrast, a lumbar medial branch block is used to determine the root cause of pain.

The following are the most commonly treated lower back conditions:

  • Herniated disc in the lumbar spinal column
  • Disc degeneration in the lumbar region
  • Spondylolisthesis lumbar.

How Fast Does Lumbar Epidural Injection Take Effect?

Your back may be uncomfortable for a few days before the steroids begin to act.

When they do, it takes between one and five days. This pain relief might continue anywhere from a few days to several months or more.

What Are The Risks Of Lumbar Epidural Injection?

Risks include bleeding, infection, and nerve injury, which are all hazards associated with any surgery involving a needle. The risk of any of these complications is extremely minimal and is frequently exceeded by the procedure's potential benefit.

The following are some contraindications to epidural steroid injections:

  • Hemophilia or anticoagulant therapy.
  • Allergens to medicine (rare)
  • Illness at a systemic level or infection that is limited to the location

The following are some of the most common adverse effects:

  • Minor injection site discomfort
  • A brief deterioration of routine discomfort
  • Flushing
  • Insomnia
  • Hyperglycemia

They are usually mild and subside within one to three days. Headaches are a less common side effect.

Lumbar Epidural Injections: General Pre- and Post-Injection Instructions

The patient may be permitted to have a small meal a few hours before the surgery. If the patient has type 1 diabetes, they should continue to eat typically before the surgery.

elderly doctor looking at notes

Patients may continue to take their regularly scheduled medicines (e.g., high blood pressure or diabetic medications).

On the day of their procedure, patients should abstain from taking pain medications or anti-inflammatory medications. These medications can be continued following the procedure if necessary.

Suppose a patient takes Coumadin (a blood thinner) or Glucophage (metformin, a diabetic medication). In that case, they must contact their treating physician to ensure that the timing of these prescriptions is understood.

In general, patients are requested to report to the outpatient facility one hour before the operation and plan to stay for around 2-3 hours.

A driver must accompany the patient and ensure their safe return home. On the day of the operation, no driving is permitted.

Patients may resume regular activities the next day, including returning to work.

How Effective Is Lumbar Epidural Injection?

Thus, a study of multiple extensive clinical studies revealed that 40% to 80% of patients saw a 50% or more improvement in sciatica pain and functional results from three months to one year after receiving one to four injections.

woman jumping air with happiness

Are you sedated to receive a lumbar epidural steroid injection?

Local anesthetic and, on occasion, intravenous sedation are used to administer the injection. Patients are not sedated or entirely unconscious during this treatment, as this is both unnecessary and dangerous.

What Does Lumbar Epidural Injection Entail?

An intravenous line (IV) is established to allow for the administration of relaxing drugs. The patient is positioned on the x-ray table lying on their side and is positioned so that the physician can view the low back optimally with x-ray guidance (sometimes called fluoroscopy).

  • The patient's back skin is washed with two different types of sterile scrub (soap).
  • The physician next injects numbing medicine into the skin region adjacent to the epidural injection site (e.g., L3-L4).
  • After the numbing medication has taken effect, the physician inserts a tiny needle into the spine's epidural space using x-ray guidance. A trace of contrast (dye) is injected to confirm that the needle is positioned correctly in the epidural space. A combination of anesthetic and anti-inflammatory medication (cortisone/steroid) is administered.

How long does it take to do a spinal injection procedure?

The treatment may take between 15 and 45 minutes, followed by recovery time. The objective is to inject the drug as closely as possible to the painful nerve.

How Long Is Recovery From Lumbar Epidural Injection?

Allow 24 hours following the injection to resume normal daily activities. Relax and stay mainly immobile while recovering after the epidural, although you should walk around occasionally.

Can I walk after an epidural steroid injection?

Generally, you may walk within a half-hour or so of receiving your epidural injection. You will, however, not be walking generally at this stage. Most clinics and hospitals will monitor you for 15 to 60 minutes following an epidural injection.

Why is the Pain Worse Following an Epidural Steroid Injection?

Due to the closeness of so many nerves, the injection is also more likely to be unpleasant than other operations.

Due to the needle's passage through many nerve clusters and directly into the spinal column, patients are likely to experience some amount of pain and discomfort regardless of whether the anesthetic is administered.

Would You Like to Learn More About Lumbar Epidural Injection?

If you reside in the Phoenix region and would like to learn more about lumbar epidural injection, we encourage you to contact Atlas Pain Specialists.

We will do an in-depth examination of your injuries and medical records and discuss the best course of action for minimizing your pain and regaining your mobility. Now is the time to schedule your same-day appointment!

About Dr. Ormond
Dr. Sean Ormond is dual board-certified in Anesthesiology and Interventional Pain Management. He completed his anesthesia residency at Case Western University in Cleveland, Ohio where he served as Chief Resident, followed by an interventional pain management fellowship at Rush University in Chicago, IL. Following fellowship, Dr. Ormond moved to Phoenix and has been practicing in the Valley for a few years before deciding to start his own practice.
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