Lumbar epidural steroid injections are the most commonly performed injections for lower back pain. A steroid solution is injected directly into the proximity of the dura, the sac that surround the roots of the nerve. This contains cerebrospinal fluid (protective fluid that contains the nerve roots).
Epidural steroid injections may also be utilized as a form of treatment for many other types of pain including leg, neck and arm pain. This treatment method has been performed successfully since the 1950′s and offers a non-surgical option associated with lower back problems. The purpose of the injections is to help alleviate pain or numbness frequently associated with leg and arm pain. As a stand-alone treatment, an epidural injection may be able to provide sufficient relief, but is usually combined with a rehabilitation therapy program in order to provide a longer-term benefit.
There are several different injection techniques that can be utilized to perform epidural steroid injections. The most common technique is the intralaminar approach where the injection is placed at the most appropriate level to ensure the best result. Another technique is the mid-line approach. The technique used depends on where the indicated pain is located.
An intralaminar epidural injection is performed by placing the injection between the bony vertebrae in the empty space that encumbers the spinal cord (epidural space). The epidural space contains the spinal and nerve roots that supply sensation and muscle control to the body, while the lower back region is responsible for the sensation to our hips and legs. Once the needle is inserted, the steroid solution is injected, which will help to reduce inflammation and alleviate the pain. A combination of steroids and local anesthetic for the injection is most frequently used.