Lumbar Epidural Steroid Injections (LESI)

ARE LUMBAR EPIDURAL STEROID INJECTIONS RIGHT FOR ME?

WHAT ARE THE INDICATIONS FOR A LUMBAR EPIDURAL STEROID INJECTION?

These injections are performed when it is thought that spinal nerve inflammation is part of the process that is causing the pain. Common indications for LESI include herniated discs, degenerative disc disease, radiculopathy or radiculitis, and spinal stenosis. Imaging studies like MRI or CT scans may also be used to identify specific areas of inflammation or nerve compression.

HOW DO EPIDURAL STEROID INJECTIONS WORK TO CONTROL MY PAIN?

The spinal cord travels from the brain to the waist in a tunnel in the back part of the spine. About every inch along the way, the spinal cord gives off branches (spinal nerves) to the right and left. These spinal nerves carry sensations and pain signals from the various parts of the body back to the brain. Corticosteroids are very potent anti-inflammatory medications that work best when they are injected into the area where the inflammation is occurring. Because the spinal nerves pass directly through the epidural space, a LESI allows the medication (steroid) to come into direct contact with the inflamed spinal nerves, reducing the pain associated with the inflammation.

PREPARING FOR TREATMENT

HOW DO I PREPARE FOR THE PROCEDURE?

You should not eat or drink anything for at least 2 hours before your procedure. You should take all of your medicines except blood thinners the day of your procedure.

WHAT SHOULD I EXPECT DURING THE PROCEDURE?

A local anesthetic will be injected into your skin to make it numb. The epidural needle will be inserted through the numbed skin and slowly advanced into the epidural space using fluoroscopy (live X-rays) to guide the needle. Once the needle is in the epidural space, a small amount of contrast will be injected under live X-ray to ensure that the medication will spread properly. After this, the corticosteroid will be slowly injected into the epidural space. Once the injection is complete, the needle will be withdrawn and a dressing will be placed over the injection site.

AFTER TREATMENT

SHOULD I REST AFTER TREATMENT?

You should rest for the remainder of the day after a lumbar epidural steroid injection, and may resume your normal activities the following day. It’s important to avoid strenuous activities for a few days to allow the injection site to heal properly. 

HOW LONG DOES IT TAKE TO EXPERIENCE RELIEF AFTER TREATMENT?

Some patients will experience immediate relief, however, it usually takes 24 to 72 hours for the effects of the steroid medication to take effect and it may be up to one week before the maximum benefits are achieved. Very often more than one injection is necessary to achieve a good level of pain relief.

ARE THERE ANY SPECIFIC SIGNS OR SYMPTOMS THAT SHOULD PROMPT IMMEDIATE CONTACT AFTER THE INJECTION?

Patients should contact their healthcare provider immediately if they experience the following symptoms:

• Severe pain
• Fever
• Redness or swelling at the injection site 
• Headaches that do not improve with lying down
• Any signs of infection or allergic reaction

These symptoms could indicate complications that require prompt medical attention.

OTHER CONSIDERATIONS

HOW LONG DO THE EFFECTS OF A LUMBAR EPIDURAL STEROID INJECTION LAST?

The duration of pain relief from a lumbar epidural steroid injection varies significantly among patients. Some may experience relief lasting for months, while others may find only temporary relief for a week or a few days. The longevity of the effect depends on the individual’s condition and response to the injection.

CAN LUMBAR EPIDURAL STEROID INJECTIONS BE REPEATED?

Yes, lumbar epidural steroid injections can be repeated. However, there is a recommended limit on the number of injections a patient can receive. Patients should typically receive no more than three injections within a 12-month period. The exact amount will depend on the patient’s response to the treatment and our assessment.