Lumbar Injections for Lower Back, Leg, and Sciatic Pain

What is a lumbar injection?

Lumbar epidural steroid injection (ESI) is a common treatment for lower back, leg, and sciatic pain. It involves the injection of a steroid or corticosteroid with a local anesthetic into the epidural space of the spine. This area is towards the center of the spine that surrounds nerve roots and the spinal cord. The steroid acts as an anti-inflammatory agent and is diluted by saline.

This treatment can be enough to manage pain on its own, but is frequently combined with physical therapy to achieve optimal treatment outcomes. It is a short-term remedy, and lessens pain from a week up to a year. No more than three injections in any one-year period is recommended. If ESIs are not providing the desired relief, other treatment options, such as radiofrequency ablation or spinal cord stimulation, may be considered.

Goals of a lumbar injection

Lower back, leg, or sciatic pain is oftentimes caused by nerve irritation, inflammation or compression in the lumbar region. If medications and other treatment options are not providing relief for this type of pain, lumbar epidural steroid injections may help. The goal is to provide sufficient pain relief to allow individuals to return to everyday activities, including participating and progressing in physical therapy. ESIs can reduce inflammation and irritation around the nerve roots and increase mobility.

How effective are epidural steroid injection treatments?

Although limited data exists on long-term effectiveness of ESIs, health care professionals generally agree that it is beneficial short-term. ESI appears to be more effective when combined with other treatment regimens. Depending on the type of pain experienced, up to 80% of individuals may find pain relief, with the greatest success being for leg pain issues.

Side effects?

Shortly following the treatment, individuals may experience numbness of the bladder and bowels, which is the most common side effect. Less common, but potential, side effects include, but are not limited to, the following:

• Bleeding
• Infection
• Nerve damage from the needle
• Temporary increase in pain
• Anxiety
• Sleeplessness
• Headache
• Facial flushing