Lumbar Epidural Steroid Injection

What is a Epidural Injection?

Epidural steroid injections, or ESIs, are a minimally invasive treatment that involves depositing a potent anti-inflammatory medication (steroid) into the epidural space, which surrounds the spine and the exiting nerves. This procedure has been used for decades to relieve low back and leg pain (sciatica). They have been shown to be effective for pain in the neck (cervical) and mid-spine (thoracic) as well. Epidural steroid injection are often effective in relieving the chronic low back pain and lumbar radiculopathy.

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Who is a candidate for Lumbar epidural Steroid injections at RA Pain Services in Washington Township NJ?

Lumbar Epidural steroid injections are used to treat chronic low back pain resulting from herniated discs, radiculopathy, degenerative disc disease, and spinal stenosis. Typically, injections are reserved for patients who have failed more conservative treatments such as physical therapy, chiropractic treatment, and anti-inflammatory medications.  During your consultation this treatment option will be discussed for the appropriate candidates.

How can I find out if I am a candidate for an Epidural steroid injection?

Only a consultation with your doctor can determine whether a epidural steroid injection would be an appropriate treatment for your condition. Epidural steroid injections are performed at RA Pain Services by our Board Certified Pain Management Specialists. Candidates for this procedure may include patients suffering with variety of conditions including cervical and Lumbar radiculopathy, degenerative disc disease, spinal stenosis, post lumbar laminectomy syndrome, herniated discs, and are often beneficial  Keep in mind that epidural steroid injections are not a cure for the condition causing your pain, but rather a means of managing your pain and discomfort to maintain function, and activity.

What kind of pain relief can I expect after epidural injections?

You may notice some reduction in your pain for the first 1-2 hours after the injection if local anesthetic is injected with the steroid. When this anesthetic wears off, your pain will return as it was before the procedure. Although pain relief with ESI generally occurs within 3 – 5 days, some patients experience improvement before or after this time period. Diabetic patients should be on the alert for a rise in blood sugar during the first few days after injection and must monitor blood sugar accordingly.

 What should I do to prepare for my epidural steroid injection?

On the day of your injection, you should not have anything to eat or drink for at least eight (8) hours before your scheduled procedure, unless told otherwise by your Physician. If you are scheduled to receive sedation during the procedure, you must have someone available to drive you home. If you usually take medication for high blood pressure or any kind of heart condition, it is very important that you take this medication at the usual time with a sip of water before your procedure.

If you are taking any type of medication that can thin the blood and cause excessive bleeding, you should discuss with your doctors whether to discontinue this medication prior to the procedure. These anticoagulant meds are usually prescribed to protect a patient against stroke, heart attack, or other vascular occlusion event. Therefore the decision to discontinue one of these medications is not made by the pain management physician but rather by the primary care or specialty physician (cardiologist) who prescribes and manages that medication. Examples of medications that could promote surgical bleeding include Coumadin, Plavix, Aggrenox, Pletal, Ticlid, and Lovenox.

 What should I expect after the procedure?

Following discharge home, you should plan on simple rest and relaxation. If you have pain at the injection site, application of an ice pack to this area should be helpful. If you receive intravenous sedation, you should not drive a car for at least eight hours. Patients are generally advised to go home and not return to work after this type of injection. Most people do return to work the next day

 Are there any risks or possible complications with epidural steroid injections?

Minor side effects from the injected medications are not uncommon and can include nausea, itching, rash, facial flushing and sweating among other things. Some patients notice a mild increase or worsening of their pain for the first day or two after injection. Fortunately Epidural Steroid Injection has an extremely good safety profile, and serious complications are quite rare. Just like any other medical procedure, there are potential complications associated with ESI including bleeding, infection, local tissue inflammation, and nerve injury.  At RA Pain services, Physicians performing the procedures are highly skilled, Fellowship Trained and Board Certified in Pain Medicine.

 What are the chances that this treatment will help my pain?

Most studies show that this treatment helps relieve pain for approximately half (50%) of the patients treated. The degree and duration of pain relief are variable and depend on many different factors, including the underlying diagnosis or condition being treated, duration of symptoms before treatment, whether previous back (neck) surgery has been performed and other factors.