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:
- 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.
- 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.
- Annular tear, a painful condition where a tear is present in the outer layer of the disc.
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 InjectionsSeveral 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.
In This Article:
- Lumbar Epidural Steroid Injections for Low Back Pain and Sciatica
- How Epidural Steroid Injections Work
- Indications for Lumbar Epidural Injections
- Epidural Injection Procedure
- Epidural Steroid Injection Pain Relief Success Rates
- Epidural Steroid Injections: Risks and Side Effects
- Epidural Steroid Injections for Back Pain and Leg Pain Video
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.