Epidural steroid injections (ESIs) have been commonly used to treat many forms of low back pain and leg pain for several years. Since 1952, they have been an integral component of the non-surgical management of sciatica and low back pain. The goal of the injection is pain relief. For many, the inject alone is enough to provide relief. However, for a greater chance of success, the injection is often combined with a comprehensive rehabilitation program.
Providing relief for one week up to one year, many practitioners agree with the benefits of injections. Although temporary, they are very beneficial for patients during an acute episode of back and/or leg pain. An ESI can often encourage progress with a rehabilitative stretching and exercise program, as it provides enough pain relief for the patient to continue with the program.
This treatment is not just for the lower back. Epidural steroid injections are used to ease pain experienced in the neck and mid spine regions.
How do Lumbar Epidural Steroid Injections Work?
ESIs deliver steroids directly into the epidural space in the spine. In some cases, additional fluid, such as local anesthetic and/or a normal saline solution, is used. The fluid helps to eliminate inflammatory mediators from around the area that may be a source of pain.
After injection, the epidural space encircles the dural sac and is filled with fat and small blood vessels. It surrounds the spinal cord, nerve roots and cerebrospinal fluid, which is the fluid that surrounds the nerve roots.
Epidural injections are often used to treat radicular pain, also called sciatica. Pain from this condition radiates from a pinched nerve in the lower back to the area of the body aligned with that nerve, such as the back of the leg or the foot. Inflammatory chemicals can also generate pain associated with common back problems like lumbar disc herniation or facet joint arthritis. These conditions and many others provoke inflammation. Inflammation is a common component of many back conditions. Inflammation can cause significant nerve root irritation and swelling. Reducing inflammation drastically helps reduce pain by taking pressure off nerves and other soft tissues. Thus, a steroid is injected as an anti-inflammatory agent, providing relief from pain.