Indications for Lumbar Epidural Injections

Several common conditions that cause severe acute or chronic low back pain and/or leg pain (sciatica) from nerve irritation can be treated by steroid injections. These conditions include:

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For these and many other conditions that can cause low back pain and/or leg pain (sciatica), an epidural steroid injection may be an effective non-surgical treatment option.

Who Should Avoid Epidural Steroid Injections

Several conditions could preclude a patient from having an injection:
  • Local or systemic infection
  • Pregnancy (if fluoroscopy, a type of X-ray, is used)
  • Bleeding problems - patient taking blood thinners (Coumadin, etc), or patients with a bleeding problem (hemophilia, etc)

Epidural steroid injections should also not be performed on patients whose pain could be related to a spinal tumor. If suspected, an MRI scan should be done prior to the injection to rule out a tumor.

Injections may be done, but with caution, for patients with other potentially problematic conditions such as:

  • Allergies to the injected solution
  • Uncontrolled medical problems such as renal disease, congestive heart failure and diabetes because they may be complicated by the fluid retention that a small percentage of patients experience for a few days after the injections.

Use of high dose aspirin or other anti-platelet drugs (e.g. Ticlid, Plavix), all of which can cause bleeding from the procedure. These medications should be stopped prior to having an injection.

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