Epidural Steroid Injections

(Cervical,Thoracic & Lumbar)
Epidural steroid injection is an effective minimally invasive treatment for some patients with low back or leg pain due to nerve impingement. Commonly, nerves which supply the back or legs are compressed near the spine either by a bulging disc, a bone spur, or by scar tissue. This causes the nerve to become irritated, inflamed and swollen. Cortisone is a powerful anti-inflammatory with the ability to decrease swelling and inflammation in this nerve, thus breaking the vicious cycle of swelling and irritation. The procedure is performed using fluoroscopy (x-ray guidance) so that the medication can be placed precisely where the physician feels it will be most effective.

Following this procedure, some patients feel a warmth or numbness in their legs from the effects of the local anesthetic. You should not drive for the remainder of the day since it is possible to have some residual weakness in your legs for a few hours. Relief from the injection generally takes about three days although some patients feel relief immediately and others do not feel relief up to a week or so. During the first few days after the injection, it is common to feel increased back discomfort from the effect of the needle having been placed. Side effects such as headache occur in less than 1% of patients. More serious complications such as infection can occur but they are exceedingly rare.

About 70% of patients who have not had previous back surgery obtain relief from epidural steroid injections. For patients who have had previous back surgery, the results are somewhat less. Many patients obtain permanent relief after one injection, but others find that their pain relief plateaus or that their pain recurs weeks, months or years later. Some patients obtain no substantial relief from the injection.