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Lumbar Epidural Steroid Injection

What is a Lumbar Epidural Steroid Injection?  

A lumbar epidural steroid injection is a minimally invasive procedure used to treat low back and radiating leg pain caused by inflammation and swelling of the spinal nerves. By delivering a steroid-based medication directly into the epidural space surrounding the affected nerve roots, this injection can help reduce pain and inflammation. 

How is a Lumbar Epidural Steroid Injection Performed?  

To perform a lumbar epidural steroid injection: 

  1. 1. The patient lies face-down, with a cushion placed under their abdomen to help open up the lumbar spine. 
  2. 2. The physician numbs the skin and tissues down to the surface of the lumbar vertebra using a local anesthetic. 
  3. 3. Under fluoroscopic (X-ray) guidance, the physician carefully inserts a thicker needle through the anesthetized track and directs it towards the epidural space between the L4 and L5 vertebrae. 
  4. 4. A contrast dye is injected to confirm the needle is properly positioned within the epidural space. 
  5. 5. Once the placement is verified, a mixture of corticosteroid and local anesthetic medication is injected to bathe the irritated nerve roots and reduce inflammation. 

What Supplies and Medications are Used for a Lumbar Epidural Steroid Injection?  

The key components include: 

  • – Local anesthetic (e.g., lidocaine) to numb the injection site 
  • – Contrast dye to visualize the epidural space 
  • – Corticosteroid medication (e.g., triamcinolone, dexamethasone) to reduce inflammation 
  • – An additional anesthetic (e.g., bupivacaine) to provide short-term pain relief 

The physician selects the specific medications and dosages based on the patient’s individual needs and condition. 

What to Expect After a Lumbar Epidural Steroid Injection?  

After the procedure, the patient may experience some mild discomfort or soreness at the injection site, but this is usually temporary and resolves within a few days. Many patients begin to experience a gradual reduction in low back and leg pain within the first week as the anti-inflammatory effects of the steroid medication take effect. 

Some patients may require additional injections over time to maintain the benefits. In some cases, it may be necessary to repeat the procedure up to 3 times within the first year for patients to experience the full therapeutic effect. The physician will provide instructions on any activity restrictions and schedule any necessary follow-up appointments. Patients should report any concerning symptoms, such as increased pain, numbness, or weakness, to their healthcare provider.

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