Lumbar Injections for Lower Back, Leg, and Sciatic Pain
Epidural steroid injection (ESI) is a common treatment for lower back, leg, and sciatic pain that has been used since the 1950s. This treatment can be enough to manage pain on its own, but is frequently combined with physical therapy to achieve better treatment outcomes.
What is an epidural steroid injection?
Steroids are injected directly into the epidural space in the spine, which is an area of blood vessels towards the center of the spine. A mixture of steroid (cortisone) and local anesthetic help to alleviate any pain, while the steroid acts as an anti-inflammatory agent. These agents are diluted by saline, which also helps to ‘flush out’ potential pain sources.
This treatment is a short-term remedy, and lessens pain anywhere from a week to as long as a year depending on the patient. No more than three injections in any one year period is often given. If epidurals are not providing desired relief, other treatment options like RF ablation and spinal cord stimulation may be considered.
How effective are epidural steroid injection treatments?
Although limited study data exists on long-term effectiveness of ESIs, doctors generally agree that it is beneficial in the short term. ESI appears to be more effective when combined with a physical therapy regimen. Depending on what type of pain is being experienced, as much as 80% of sufferers may see relief, with the greatest success being for leg pain issues.
What are the risks and side effects?
Shortly after the treatment, patients may experience numbness of the bladder and bowels, which is the most common side effect. Less common side effects include bleeding, infection, and nerve damage from the needle or above listed side effects.
Steroid-sensitive patients may experience side effects from the drug, including a temporary increase in pain, anxiety, sleeplessness, headache, and facial flushing. These side effects, although possible, are generally rare.