The dura is a protective covering of the spinal cord and its nerves. The area surrounding the dura is the epidural spaces In the lower back, this space is called the lumbar epidural space.
What Causes Pain In The Epidural Space?
The lumbar area ofthe spine has ﬁve bones, called vertebrae. Soft discs between the vertebrae act as cushions, offering support and helping to control motion. lfa disc tears, chemicals inside may leak out, causing inﬂammation of nerve roots or the dura, and pain. A large tear may cause a disc to bulge, resulting in inﬂammation and pain. Bone spurs, called osteophytes, can also press against nerve roots and cause pain.
How Do I Know If I Have Disc And Nerve Root Pain?
Your doctor can determine the cause of your pain. lt‘you have pain in your lower back when you move, you may have disc or dural inﬂammation. If pain travels to your leg when you bend your back, you may have nerve root inﬂammation.
Common tests, such as MRls, can show disc bulges and nerve root comprcssion, but may not show a torn and leaking disc‘ A lumbar epidural injection can help detennine ifdisc, dural, or nerve root inﬂammation is causing your pain.
What Is A Lumbar Epidural Steroid Injection?
During this procedure, a local anesthetic (numbing medicine) and a corticosteroid (anti-inﬂammatory medicine) are injected into the epidural space to reduce inﬂammation Your physician may inject into this space from behind. This is called an interlaminer injection When your physician goes in from the side, it is called a transforaminal injection. lfthe needle is positioned next to an individual nerve root, it is called a selective nerve root block. When performed from below it is called a caudal injection.
What Happens During An Injection?
A local anesthetic may be used to numb your skin. The doctor will then insert a thin needle directly into the epidural space. Fluoroscopy, a type of x—ray, may be used to ensure the safe and proper position of the needle. A dye may also be injected 10 make sure the needle is in the correct spot. Once your physician is sure the needle is correctly placed, the medicine will be injected.
What Happens After An Injection?
You will be monitored for up to 30 minutes after the injection. Before you leave, the clinic will give you discharge instructions as well as a pain diary. Keeping track of your pain helps the doctor know what the next steps will be, You may want to check for pain by moving your back in ways that hurt before the injection, but do not overdo it. You may feel immediate pain relief and numbness in your back and leg for up to six hours after the injection. This means the medication has reached the right spot. Your pain may return after this short pain-free period, or may even be a little worse for a day or two. This is normal. It may be caused by needle irritation or by the steroid itselﬁ Steroids usually take two or three days to start working, but can take as long as a weeks You should be able to return to work the day alter the injection, but always check with your doctor,
How Long Can I Expect Pain Relief?
Depending on the amount of inflammation, an injection could offer several months of pain relief before Further treatment is needed. For some, a single injection could result in long-term pain relief. lf your pain is caused by injury to more than one area, only some of your symptoms will be helped by a single injection.