Lumbar Epidural Injection

What is a lumbar epidural steroid injection?

An epidural steroid injection is used to treat pain arising from irritation of spinal nerves and discs. Steroid medications, designed to reduce inflammation, are injected into the epidural space. The epidural space is a space in the spine superficial to the spinal cord where spinal nerves travel.

Are there safety concerns?

In 2012 there was an outbreak of meningitis caused by contaminated steroids. All cases came from facilities that used medications that were mixed in an unclean environment. The Los Angeles Minimally invasive Spine Institute only uses medications that are mixed in the operating room under clean and sterile conditions at the time of injection.

How is an epidural steroid injection performed?

The physician places a small needle through the skin of the lower back and through a natural opening in the bones of the spine. The needle then is directed into the epidural space where spinal nerves travel. A small amount of x-ray dye shows the doctor that the needle is in the correct location. The injection includes a mixture of medications that reduce inflammation and medications that reduce pain. Epidural injections can be performed in the neck, upper back or low back. They can be placed in the middle of the spine, between the back of the vertebrae. This is an interlaminar injection. Epidural injections can also be performed at the exit point where the nerves leave the spine, the foramina. This is a foraminal injection.

How long will the procedure take?

Allow yourself an hour to be prepared for the procedure. The actual procedure will take about 15 to 30 minutes. After the procedure you will recover for 30 minutes to an hour before going home.

What is the recovery like?

You can generally return to your normal activities by the next day. You can shower the same day as the procedure.

The 4 Pillars of Treating Chronic Spinal Pain

George Rappard MD discusses the 4 key pillars of spine care. The 4 pillars are physical therapy and chiropractic care tailored to your condition, appropriate selection of medical therapy, pain injections targeting your specific pain source and, as a last result, minimally invasive motion and stability preserving spinal surgery performed as an outpatient procedure. Through effective use of the first 3 pillars only about 5% of our patients need to go on to have back surgery or neck surgery.

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