Lumbar Epidural Injections

Pain signals normally travel along the nerves to the brain, where they are experienced as pain. When a nerve becomes irritated or compressed, it can send excessive signals that cause persistent or debilitating pain. Nerve block injections are a minimally invasive treatment designed to temporarily interrupt or reduce the transmission of pain signals along specific nerves.

One of the components of an epidural nerve block is an anesthetic medication, such as lidocaine. This is the same type of medication used to “freeze” your gums at the dentist. When used in a nerve block injection, the anesthetic medication temporarily numbs the targeted nerve or group of nerves, preventing them from transmitting pain signals to the brain.

A steroid medication – cortisone is included in the injection to reduce inflammation in the surrounding tissues and provide longer-lasting relief.

A lumbar epidural nerve block is used to manage pain originating from spinal nerves in the lower back. It is most often used for conditions that involve nerve compression or irritation such as: 

• Herniated discs –  Discs of connective tissue that normally sit between the vertebrae can herniate or bulge out and compress nearby nerves, causing pain, numbness, or weakness that radiates from the lower back down into the legs.
• Sciatica – This occurs when the sciatic nerve is compressed, often due to a herniated disc or spinal stenosis. Symptoms include sharp, radiating pain down one or both legs, sometimes accompanied by tingling or weakness.
• Spinal Stenosis – This condition involves the narrowing of the spinal canal, which puts pressure on the spinal cord or nerve roots. This can cause pain, numbness, or weakness in the lower back and legs. 
• Degenerative Disc Disease – Spinal discs can deteriorate over time, leading to pain and inflammation in the lower back.
• Radiculopathy – This condition is caused by irritation or compression of nerve roots in the lumbar spine, leading to pain that radiates down the legs, similar to sciatica.
• Spondylolisthesis – This condition occurs when one vertebra slips forward over the one below it, potentially compressing spinal nerves and causing lower back and leg pain.

By blocking pain signals and reducing swelling around the affected area, a lumbar epidural nerve block can reduce pressure on your nerves, decrease your pain, and improve your mobility.

Nerve block injections are a safe, minimally-invasive treatment that can greatly improve your quality of life, restore physical function, and help you meet your long-term recovery goals.

Non-surgical alternative: Nerve block injections are an effective option for managing pain without the need for surgery.

Precise pain relief: The injection targets specific nerve roots or inflamed areas, addressing the source of discomfort directly. This can reduce the need for oral pain medications, including potentially addictive opioids.

Improved mobility and function: By reducing pain, nerve blocks allow you to resume your daily activities and participate more effectively in physical therapy — so you can progress towards recovery.

Diagnostic benefits: Nerve block injections can pinpoint the exact source of pain, which can help guide further treatment decisions.

Nerve block injections have a high rate of success. 70% to 90% of patients experience significant pain relief, lasting from several weeks up to one year. 

It’s important to understand that the pain relief from a nerve block injection is usually temporary. Over several weeks to months, the effects of the medication will gradually wear off.  Depending on your condition and results, the injections can be repeated up to 3-6 times per year to get sustained relief.

Yes, nerve blocks are a safe and widely used medical procedure. At Wilderman Medical Clinic, we utilize ultrasound imaging techniques to ensure the highest level of precision and minimize the risk of side effects. If side effects do occur, they are usually mild and temporary, such as slight swelling or soreness at the injection site.

Nerve blocks are often a good option for patients who experience chronic or acute pain that hasn’t responded well to other treatments. However, people with some conditions may not be a good candidate for nerve block injections:

• Medication allergies: You must not be allergic to the medications used in the injection.
• Infections: An active infection near the injection site or in your body could increase the risk of complications. 
• Bleeding problems: If you have a blood clotting disorder or take blood thinners, a doctor will ask you to stop taking your medication for a few days before an epidural injection due to the risk of uncontrolled bleeding. You will be able to re-start taking this medication after the procedure.
• Serious health issues: Conditions like uncontrolled diabetes or severe heart problems might make this procedure unsafe for you.
• Pregnancy: Nerve block injections may not be recommended during pregnancy.

Our expert clinical team will assess your unique situation to determine if a nerve block is right for you.

At Wilderman Medical Clinic, we take every precaution to ensure your safety. Serious complications are rare, but there are some potential risks including:

• Vasovagal response (fainting or passing out)
• New or increased pain
• Infection
• Bleeding
• Permanent skin changes
• Allergic or unexpected drug reactions 
• Accidental nerve injury

During your initial consultation, our clinical team will go over the potential risks and benefits with you to make sure you feel confident and well informed before going ahead with the procedure.

Our expert team will prioritize your comfort and safety throughout the process:

Consultation: Before your procedure, our physicians will discuss your medical history, symptoms, and treatment goals to determine if a nerve block is the right option for you.

Preparation: The skin is cleansed with a sterilizing solution and a local anesthetic medication is usually given to numb the skin. 

Injection: Next, our experienced clinician will use ultrasound to precisely locate the target nerve. A thin needle is directed to the desired location, and the medications are injected. The whole process typically takes less than 30 minutes. Most patients report only minimal discomfort during the injection.

Recovery: After the injection, a small bandage is placed on your skin. You will be given time after the procedure to make sure you feel good and are not having side effects before leaving the clinic. For your safety, you will be required to have a driver pick you up to ensure you get home safely.

Most patients can resume normal activities within a few hours, although rest is recommended for the remainder of the day. Minor soreness for a week after the procedure is normal.

We follow up with all of our patients after their procedures, typically within 2-4 weeks.

Ready to take the next step toward lasting pain relief? Our expert team will work with you to find the best pain management option for you — so you can take control of your pain and restore your quality of life.

Contact us today to schedule your consultation and discover if a nerve block injection is right for you.

https://www.spine-health.com/treatment/injections/lumbar-epidural-steroid-injections-low-back-pain-and-sciatica

https://my.clevelandclinic.org/health/treatments/22091-lumbar-epidural-steroid-injection

Carassiti M, Pascarella G, Strumia A, Russo F, Papalia GF, Cataldo R, Gargano F, Costa F, Pierri M, De Tommasi F, Massaroni C, Schena E, Agrò FE. (2021) Epidural Steroid Injections for Low Back Pain: A Narrative Review. Int J Environ Res Public Health. 2021 Dec 26;19(1):231. doi: 10.3390/ijerph19010231. PMID: 35010492; PMCID: PMC8744824.