How painful is a lumbar epidural steroid injection?

An epidural steroid injection is an injection of local anesthetic and steroid into the epidural space. Due to disc herniation, lots of chemical inflammatory substances are released in the epidural space and the goal is to provide pain relief by reducing the inflammation (swelling) of the nerve roots as they exit the spine. Once skin is anesthetized with local anesthesia then you will feel tight sensation when the medicine is being injected. Many patients are done under sedation so procedure is mostly painless.

How long do epidural injections last for back pain?

The long acting steroid starts working in about 2 to 5 days and its effect can last for several days to a few months. At our pain management clinic our pain doctors have achieved great results and some of the patients had long term pain relief.

How many do I need to have?

If the first injection relieve your symptoms partially, more than 50% then within two weeks, you will be recommended to have a second injection.

What are the side effects?

  • Localized increase in pain.
  • Non-positional headaches resolving within 24 hours.
  • Facial flushing.
  • Anxiety.
  • Sleeplessness.
  • Fever the night of injection.
  • High blood sugar.
  • A transient decrease in immunity because of the suppressive effect of the steroid.

Can I go back to work after epidural steroid injection?

Patients are generally advised to go home and not return to work after this type of injection same day. Our Pain specialists recommend a day off if you have increased pain or temporary weakness in the legs following the injections.

What is the success rate?

Recent research reports that lumbar epidural steroid injections are successful in patients with persistent sciatica from lumbar disc herniation, with more than 80% of the injected group with disc herniation experiencing relief (in contrast to 48% of the group that received a saline placebo injection).

Are epidural steroid injections dangerous?

What are the risks? An epidural steroid injection generally causes no problems. If you do have side effects, they may include: “Steroid flush,” or flushing of the face and chest, with warmth and an increase in temperature for several days.

Sources

  1. https://www.brighamandwomens.org/anesthesiology-and-pain-medicine/pain-management-center/epidural-steroid-injections
  2. http://www.medcentral.org/Main/EpiduralInjection.aspx
  3. https://www.spine-health.com/treatment/injections/epidural-steroid-injections-risks-and-side-effects
  4. http://www.spinedallas.com/epidural-steroid-injection-interventional-spine-pain-doctor-dallas-tx.html
  5. https://www.spine-health.com/treatment/injections/epidural-steroid-injection-pain-relief-success-rates