Lumbar Epidural Steroid Injection

Lumbar epidural steroid injection is performed to relieve low back pain and radiation of the pain to the legs. Steroid medication can reduce the swelling and inflammation caused by spinal conditions. In some cases it may be necessary to repeat the procedure as many as 3 times to get the full benefit of the medication. Many patients get significant relief from only one or two injections. The patient usually lays facedown. A cushion under the stomach is provided for comfort. In this position the spine opens and allows for easier access to the epidural space. The fluoroscopy assists the physician in locating the appropriate lumbar vertebra and nerve roots. A local anesthetic is used to numb the skin. All the tissues down to the surface of the lumbar vertebral bone are anesthetized. The physician slides a thicker needle through the anesthetized tract. Using the fluoroscope for guidance, the physician slides the needle towards the epidural space at the appropriate levels. A contrast solution is injected. The physician uses fluoroscope to see the painful areas and confirm the correct location of the needle tip. A steroid/anesthetics mix is injected into the foraminal epidural space, bathing the painful nerve root with soothing medications. Then, the needle is removed, and a small bandage is applied to cover the tiny needle surface wound.