- Lower back
- Leg pain
The lumbar section of the spine has five bones or vertebrae. Soft discs between these vertebrae hold them together, cushioning them and controlling motion. If a disc tears, chemicals inside may leak out causing an inflamed nerve root or even a disc bulge. Bone spurs can also press against nerve roots and cause pain.
Lower back pain when you bend your back may indicate a lumbar disc and dural inflammation. If your pain travels to your leg you may have nerve root inflammation. Because tests such as MRIs may not show a torn or leaking disc, a thoracic epidural injection helps determine if disc or dural problems, or nerve root inflammation are causing your pain.
This procedure consists of an anesthetic and a steroid being injected into the epidural space in order to reduce inflammation. If the needle is positioned next to an individual nerve root, it’s considered a selective nerve root block and medication is placed directly along an inflamed nerve root.
The injection may begin with an IV to help you relax, and a local anesthetic to numb your skin. The physician then inserts a thin needle into the epidural space. Fluoroscopy, a type of X-ray, is used to ensure proper needle placement and a dye may also be injected to make sure the needle is in the correct spot. Once the needle is correctly placed, the physician injects the anesthetic and steroid.
You will be monitored for 30 minutes following the injection, at which time you will be given your discharge instructions and be allowed to leave the clinic. You may notice immediate relief and numbness in your back and leg for a few hours after the injection, which means the medication has reached the correct spot. It’s normal for your pain to return after this initial pain-free period, and it may even worsen for a day or two. You may be able to return to work the following day, but always make sure to consult your physician.
The steroid will start working after a couple days, but can sometimes take up to a week. Relief varies from person to person, and depends on the amount of inflammation involved. Sometimes this injection brings several months of pain relief and sometimes long-term relief is acquired.