During an epidural injection for back and leg pain, a physician delivers pain relief medicine into the epidural space, a space that surrounds your spinal cord. The injection could deliver a steroid, or corticosteroid, to provide long-lasting relief from chronic back and leg pain.

Epidural injections for back pain are minimally invasive treatments and can be a key part of interventional pain management. This process focuses on treating pain at its source without relying on invasive surgery or long-term use of medication.

How it works

Back and leg pain often stems from nerve compression caused by problems with the surrounding tissue that create inflammation.

The corticosteroids used in epidural injections help reduce inflammation and ease pressure on nearby nerves.

Your doctor will place the injection directly into the epidural space (a part of the spine that surrounds the spinal cord and nerve roots). The procedure places the steroid at the source of the inflammation to try to provide fast, focused relief without affecting the rest of the body.

Conditions it can help treat

These injections can help ease back and leg pain and pain that radiates into other parts of the body from the spine. The pain can be the result of a sports injury or similar trauma or it could stem from a chronic condition. Here are a few examples:

• Pinched nerves. Epidural injections alleviate pain and improve movement by reducing inflammation around the compressed nerve.
• Lumbar radiculopathy (sciatica). The injection calms irritated nerve roots, helping relieve lower back pain and radiating leg pain.
• Herniated discs. The steroids reduce swelling around the disc, which in turn relieves pressure on neighboring nerves.
• Spinal stenosis. The injection opens up space around crowded nerves, providing relief from pain, numbness, and stiffness.

What to expect during the procedure

We’ll walk you through a lumbar epidural steroid injection procedure, which focuses on the lower back, to provide a general idea of how these injections work.

• Outpatient process. With this minimally invasive procedure, you won’t have to stay overnight in a hospital. You’ll be able to go home shortly after it’s over.
• Procedure preparation. The procedure itself involves lying down on your belly in a medical gown. After cleaning the injection site to prevent infection and administering local anesthesia to minimize discomfort, the doctor will insert the epidural needle.
• Use of fluoroscopic guidance. Fluoroscopy imaging guidance (an advanced form of real-time X-ray technology) helps the physician insert the needle directly into the epidural space with maximum accuracy. Once in place, a small amount of contrast material is injected to confirm the needle’s position and ensure the medication will flow to the intended area. Next, the provider slowly injects the corticosteroid.
• Recovery and follow-up. A lumbar epidural injection for back pain normally takes around 15 to 30 minutes to perform. After the injection, you’ll move to a recovery area to rest before being released to go home. This allows the medical team to monitor you to make sure you don’t experience any unusual side effects or complications. Physicians usually recommend a follow-up visit.

How effective are lumbar epidural injections?

You’ll likely notice immediate pain relief due to the local anesthetic applied during the procedure, but your pain may worsen once the numbing goes away. This pain may last for a day or two before the steroid medication starts reducing inflammation and easing nerve pressure. Most people report significant pain relief within two to seven days.

The pain relief you enjoy from the injection can last anywhere from several days to several months. Your underlying condition and overall health will both impact how long the relief lasts. For most people, epidural injections do not provide a cure for back pain.

Those experiencing chronic pain or recurring nerve inflammation often go back to receive repeat injections. But most doctors have a limit of two to three injections per year. People with chronic issues in the lumbar region often need additional therapies, such as physical rehab or oral medication, for lasting pain relief.

Who’s a good candidate?

Epidural steroid injections are usually reserved for patients who have exhausted more conservative approaches. If you’ve tried rest, physical therapy, medicine, and lifestyle modifications with no lasting relief or significant improvement, you’re likely a good candidate.

Most physicians do not recommend this therapy as a primary method of care. This is because injections provide superior targeted pain relief but the addition of physical therapy provides more long term relief.

Your doctor will probably prescribe the injection(s) in combination with one or more other treatment methods—simply numbing the pain will not provide lasting pain relief. You must treat the underlying cause to achieve long-term improvement. Ideal candidates understand that an epidural injection for back pain is just one piece of the puzzle for long-term pain management.

Patients with specific conditions like spinal stenosis, herniated discs, or sciatica tend to benefit most. These kinds of pain often come from swelling or pinched nerves, and injections can bring quick relief.

When to talk to your doctor

You should talk to your doctor about getting an epidural injection if more conservative methods haven’t worked after six weeks. A good first step is speaking with a pain management or neurology specialist at Florida Medical Clinic Orlando Health’s Interventional Pain Management Department.

We’ll listen to your concerns and do a thorough evaluation, using advanced imaging techniques as needed, to pinpoint your pain source. We offer a wide range of treatments for back pain relief, including intradiscal treatment, medication management, spinal cord stimulation, epidural injections, radiofrequency ablation, and more. Our approach focuses on pain relief that lasts, so you can stay active and comfortable long-term.

About Dr. Temperato

Dr. Kathy Temperato has advanced training in the subspecialties of sports musculoskeletal medicine and interventional spine medicine. She tailors her approach to treating back and leg pain to each individual’s way of life and their specific objectives by using a holistic, patient-centered approach.

Her expertise includes managing spinal conditions such as disc degeneration and nerve compression. When conventional pain treatments fail, she can provide patients with cutting-edge procedures like lumbar RFA performed under fluoroscopic guidance to alleviate back pain without the need for surgery.

Request an appointment by calling (813) 977-6688.