Epidural steroid injections offer relief for patients who have lower back pain and leg pain. This non-surgical method of treatment can be very effective for treating patients with sciatica and lower back pain.
The epidural space on the spine contains lymphatics, spinal nerve roots, loose fatty tissue and a network of blood vessels and small arteries. Inflammation of the nerves roots due to a damaged disc, contact or injury can cause uncomfortable pain in the lower back and legs.
Who is a candidate for Epidural Steroid Injections?
People who suffer from lower back or leg pain due to inflammation of the spinal nerves can benefit from epidural steroid injections. There are many conditions that can cause this. The most common conditions we see and treat with this injection include:
- Spinal Stenosis: When the spinal canal (the space in the vertebral column that is formed by vertebrae where the spinal cord passes through) begins to narrow, it will result in pressure being put on the spinal cord or spinal nerves. This condition is known as spinal stenosis. It can occur anywhere along the spine but is commonly seen in the lower back (the lumbar spine). It can lead to significant pain in your back and can radiate down your legs.
- Herniated Disc: The rubbery cushions between each vertebra are called intervertebral discs. A herniated disc (also called ‘slipped’, ‘ruptured’, or ‘prolapsed’ disc) is when the tough outer shell of the disc is cracked and the soft jelly-like contents begins to seep out. When the contents come in contact with the nerves, it can lead to chronic pain. It is most commonly seen in the lower back (the lumbar spine).
- Degenerative Disc: As we age, our intervertebral discs will undergo natural changes. These discs help us with everyday movements like bending, twisting, and flexing and also act as shock absorbers for the spine. During the aging process the disc will go through the process of degeneration resulting in small tears or cracks that will make them weak. It is most commonly seen in the lumbar region and cervical region (neck) of the spine.
- Sciatica: The sciatic nerve runs from your lower back, through the pelvis and down each leg. Sciatica results in pain caused by issues with the sciatic nerve that will lead to inflammation. Sciatica pain is located in the lower back and can spread to the hips, buttocks and down the leg.
How does it work?
The injection delivers a dose of steroids and anesthetic into the epidural space in the spine. This results in very potent anti-inflammatory actions that will provide relief for back and leg pain. It will not cure the underlying cause of the pain but will break the inflammation and pain cycle.
After your injections, you may feel relief in one to three days but sometimes it can take a week to feel the benefits. In general, most people can tolerate the steroid injection very well. Some people may experience more than usual pain that will subside, temporary bruising, flushing of the face for an hour or two, minor anxiety, and trouble sleeping. All of these should disappear in a few days and are not permanent.
The treatment may provide permanent or temporary relief and is often used as part of a interdisciplinary treatment plan while the injury or source of pain is being treated and healed. In rare cases, some people do not experience much relief from pain. Most people, however, will experience some form of pain relief that will help you with everyday movements and will last for several months or longer.