Lumbar Epidural Steroid Injection
Your doctor has suggested that you have a (LESI) Lumbar Epidural Steroid Injection
LESI is a non-surgical treatment that can help relieve low back and leg pain caused by irritation of the spinal nerves, and is performed to relieve pain caused by spinal stenosis, spondylolysis, or disc herniation.
The epidural injection delivers a long-lasting steroid and an anesthetic agent to the irritated and inflamed spinal nerve. Medicines are delivered to the nerve through the area between the protective covering of the spinal cord and vertebrae called the epidural space.
Who is a candidate for LESI?
Patients with pain in the low back or leg caused by the following conditions may benefit from a LESI.
- Spinal Stenosis: A narrowing of the spinal canal and nerve root canal causing back and leg pain.
- Spondylolysis: A weakness or degeneration between the upper and lower facets of a vertebra. If the vertebra slips forward, it can compress the nerve roots causing pain.
- Herniated Disc: Occurs when the gel-like center of an intervertebral disc pushes out from the center, similar to the filling being squeezed out of a jelly doughnut. Pain results when the disc material touches a nearby nerve.
Who performs lumbar epidural steroid injections?
At Saint Alphonsus Medical Center – Baker City, the LESI is performed by a Certified Registered Nurse Anesthetist (CRNA).
Benefits of LESI
LESI has proven helpful in the treatment of the previously mentioned painful inflammatory conditions. It can also help to determine if surgery might be beneficial for pain associated with a herniated disc.
LESI can ease the pain when symptoms interfere with rehabilitative exercises.
LESI should NOT be performed when:
- An infection is present
- A woman is pregnant
- Bleeding problems are present.
Getting ready for the procedure
- Bring a list of all medications.
- A minimum of 5 days before the injection, stop taking all blood thinners and anti-inflammatory medications.
- Do not eat or drink anything for 6 hours prior to the injection.
- Arrange for an adult to drive you home and stay with you for the first 4 hours after the procedure.
- Check in at the Admitting Department to register and complete paperwork.
- The admitting clerk will accompany you to the Day Surgery Area.
- A nurse will verify your name, date of birth, and the procedure.
- Vital signs and a medical history are documented.
- An IV line will be placed for medication and/or fluids.
What happens during and after the procedure?
The actual procedure only takes a few minutes. Extra time is allowed for preparation and recovery.
- Medication may be given to help you relax.
- Heart rate, breathing and blood pressure will be monitored by devices attached to your chest and side.
- Your back will be cleaned and may be covered with sterile towels.
- Medicine will be given to numb the skin near the injection site.
- A local anesthetic and/or steroid are injected into the epidural space.
- You will spend approximately one hour in the day surgery area.
- A neurological check is done to check for numbness, tingling, pain or weakness.
Common side effects are:
- Brief increase in pain
- Trouble sleeping
- If any side effects last more than 24 hours, call your doctor or seek medical treatment.
What are the results?
An LESI won't stop all low back and leg pain, but it can reduce pain and break the cycle. Getting back on your feet can speed up recovery. Lack of movement can slow down healing.
Some people may feel more relief from an injection than others. Most injections come in a series of three injections, three to six weeks apart.
The benefits of LESI tend to be temporary. Some patients experience pain relief for as little as 1 week and others for up to 1 year. Most importantly, patients may experience enough relief to resume normal activities and/or continue a physical therapy program.
What happens after I go home?
- Most patients are able to walk immediately following the procedure.
- Take it easy for 24 to 36 hours to allow the anti-inflammatory benefits to take effect.
- Most patients can resume normal activities and/or participate in their physical therapy program within a few days after the LESI.
- Localized soreness is usually relieved within 24 hours by using ice, reducing strenuous activities, and taking a mild analgesic.
- To help the healing process, patients are advised to reduce their work schedule and activities for 48 hours following the procedure.