Epidural injections are a common treatment option for many forms of low back pain and leg pain. They have been used for low back problems since 1952 and are still an integral part of the non-surgical management of sciatica and low back pain. The goal of the injection is pain relief; at times the injection alone is sufficient to provide relief, but commonly an epidural injection is used in combination with a comprehensive rehabilitation program to provide additional benefit.
Most practitioners will agree that, while the effects of the injection tend to be temporary – providing relief from pain for one week up to one year – an epidural can be very beneficial for a patient during an acute episode of back and/or leg pain. Importantly, an injection can provide sufficient pain relief to allow a patient to progress with a rehabilitative stretching and exercise program.
How Epidural Injection Work?
An epidural injection delivers medicine directly into the epidural space in the spine. Sometimes additional fluid (local anesthetic and/or a normal saline solution) is used to help ‘flush out’ inflammatory mediators from around the area that may be a source of pain.
The epidural space encircles the dural sac and is filled with fat and small blood vessels. The dural sac surrounds the spinal cord, nerve roots, and cerebrospinal fluid (the fluid that the nerve roots are bathed in).
Several common conditions that cause severe acute or chronic low back pain and/or leg pain (sciatica) from nerve irritation can be treated by injections. These conditions include:
- A lumbar disc herniation, where the nucleus of the disc pushes through the outer ring (the annulus) and into the spinal canal where it pressures the spinal cord and nerves. Read Lumbar Herniated Disc for more information on diagnosis and treatments.
- Degenerative disc disease, where the collapse of the disc space may impinge on nerves in the lower back.
- Lumbar spinal stenosis, a narrowing of the spinal canal that literally chokes off nerves and the spinal cord, causing significant pain.
- Compression fractures in a vertebra.
- Cysts which are in the facet joint or the nerve root and can expand to squeeze spine structures.
The epidural injection procedure takes place in a surgery center, hospital, or a physician’s clinic.
Epidural Injection Pain Relief Success Rate
Patients will find that the benefits of an epidural steroid injection include a reduction in pain, primarily in leg pain (also called sciatica or radicular pain). Patients seem to have a better response when the epidural injections are coupled with an organized therapeutic exercise program.