Epidural steroid injections are used to treat lower back, spine, and leg pain. They have been utilized by doctors since the 1950’s and they are still an important part of non-surgical treatment of sciatica and lower back pain. These injections provide pain relief and are typically used in combination with an ongoing pain management plan set up by the doctor.
The injections are effective because they deliver the medication directly into the epidural space inside the spine. The epidural space surrounds the dural sac which in turn surrounds the spinal cord. The space is filled with fat and small blood vessels. Injecting the medication in this area helps deliver the medicine to the exact area of discomfort. The injections themselves are usually comprised of a steroid, such as cortisone. These act as an anti-inflammatory. Lidocaine can also be used to relieve pain and can also flush the area of chemical or immunologic agents which can cause inflammation.
The process for injecting the medicine will usually take about 15 to 30 minutes. The patient will lie flat on an x-ray table and may lay with a pillow under their stomach to lift up their back. If this causes pain, the patient will be allowed to sit or lie in another position. The area of the injection will be cleaned and then numbed with a local anesthetic. Then the doctor will use the fluoroscopy, or live x-ray, to guide the needle into the epidural space. Once the needle is in the right spot, a contract dye is injected to confirm the needle’s location. With this confirmed, the medication is then injected. This will be done slowly, though patients may feel some pressure. The patient will be allowed to return home after being observed for about 15 to 20 minutes. This ensures that the pain has been successfully treated and the patient is doing well.