Lumbar Epidural Steroid Injection

What is Lumbar Epidural Steroid Injection?

Lumbar Epidural Steroid Injection or (ESIs) is a medical care of choice for a number of types of low back pain and leg pain.  This treatment option has been used since its inception in 1952 and remains to be an important part of the non-surgical management if not conservative alternative in addressing sciatica and low back pain.  The main objective of the procedure is to alleviate pain.  In numerous cases, the procedure alone is enough to stop the pain, but in practice, an epidural steroid injection is administered in conjunction with a bespoke rehab (including physical therapy) to produce additional comfort.

Low Back Pain

Severity of low back pain can vary from mild to debilitating. While pain may not be constant, there is potential for the condition to worsen with time. Depending on the cause, common symptoms include:

  • muscle spasms,
  • tightness of the lower back,
  • burning or stinging pain, and
  • difficulty performing certain activities

Leg Pain

Leg Pain is usually a result of overuse, wear and tear, or injury in the joint, bone, muscle, tendon, ligaments or soft tissues. In some cases, the leg pain is a symptom of a particular lower spine problem, poor circulation, varicose veins or blood clots. Depending on the cause, the leg pain may be:

  • burning,
  • throbbing,
  • aching or searing.
  • It may also come with tingling or shooting sensation and numbness

What does the procedure look like?

Lying face down, the patient puts a pillow under the abdominal area for additional comfort as it flexes the back.  With the patient in this position, the spine opens up which makes it easier for the physician to access the epidural space.

To desensitize the skin, a local anesthetic is applied to numb the tissue from the surface of the lamina up to the lumbar vertebrae bones.  Then the doctor inserts a bigger needle through the anesthetized track.

The doctor inserts a contrast solution via the needle through the epidural space in between the L-4 and L-5 vertebra.  The doctor utilizes a fluoroscope (a kind of x-ray equipment) to ensure that the end of the needles is accurately in place within the epidural space.  Then, a contrast solution is administered.  Injected through the track, the contrast dye needle securely positioned close to the inflamed nerve roots. The doctor utilizes the fluoroscope to validate the position of the needle tip.

Following the careful validation of the needles exact position, the doctor positions a steroid-anesthetic medication.  This prescription bathes the inflamed nerve roots which will help ease the pain being experienced by the patient.

After the procedure, the needle is withdrawn and the entry point in the skin is cleaned and bandaged.  Some of the patients that undergo this procedure requires only one injection. For others, it will require more than one injection before the pain is alleviated.

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