Center for Pain Management

Lumbar Epidural Steroid Injection

No matter if performed at the lumbar, cervical, or thoracic level of the spine, an epidural steroid injection is a common procedure to treat spinal nerve irritation caused by tissues next to the nerve pressing against it. The nerve root is most often irritated by an inflamed intervertebral disc directly touching the spinal nerve.

An epidural steroid injection involves bathing an inflamed nerve root in steroids (potent anti-inflammation medicine) in order to decrease the irritation of the nerve root that is causing pain.  Epidural steroid injections are most commonly used in situations of radicular pain, which is a radiating pain that is transmitted away from the spine by an irritated spinal nerve. Irritation of a spinal nerve in the low back (lumbar radiculopathy) causes pain that goes down the leg. Epidural injections are also used to treat nerve compression in the neck (cervical spine), referred to as cervical radiculopathy.

The spinal cord itself rests in the spinal canal. The nerve roots branch out from the spinal cord at each level of the vertebae (the bony building blocks of the spine). The cord is protected by cerebrospinal fluid (CSF), which serves as a sort of shock absorber for the cord. The CSF is held in place by a membrane with several layers, one of which is called the dura.  The epidural space is outside of this tough membrane.

During an epidural steroid injection, a needle and syringe are used to enter the epidural space and deposit small amounts of long-lasting steroids around the inflamed spinal nerve. A fluoroscope (a viewing instrument using X-rays) is used to see the appropriate anatomy during the injection. The epidural steroid injection specifically targets the inflamed area and treats it with a maximal amount of steroids, thereby minimizing exposure of the rest of the body to the steroids.