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A lumbar epidural injection, which contains a numbing medicine and a steroid, won’t stop all low back and leg pain for everyone. But it can reduce pain and break the pain cycle for many patients. This cycle may begin when back pain makes it hard to move. Lack of movement can then slow down the healing process. By getting you back on your feet, the injection can help speed your recovery.

Some people may feel more relief from an injection than others, and some people may need more than one injection to get relief. Usually, no more than four injections are done in a 12-month period. If the first injection did not help, it is less likely that another one will help, but it may help your doctor know if a different type of procedure may be an option.

What is a lumbar epidural injection?

An epidural injection can help locate the source of pain. Also called a selective nerve root block or a transforaminal epidural, it numbs the roots of specific nerves. The effect is temporary, but if you feel relief, it may indicate the source of the pain. If you feel no relief, it may mean that the pain’s source is at another place in your spine, or it may mean that something other than inflammation is causing the pain. Injection results also may be used to help plan back surgery, if needed.

Possible Risks and Complications

Some risks of lumbar epidural include:

  • Spinal headache
  • Bleeding (rare)
  • Infection (rare)

Getting Ready

Typically, a lumbar epidural injection is an outpatient procedure performed without the need of sedation under local anesthesia. You may need to do the following:

  • Give your healthcare provider a list of all medicines you take, such as aspirin and anti-inflammatories. This includes prescription and over-the-counter medicines. It includes any vitamins, herbs and other supplements. It is especially important to tell your providers if you are taking a medication that thins your blood. You may need to stop taking some of your medicines before the injection, especially the stronger blood thinners.
  • Although the procedure is performed with local anesthesia, it is helpful to have an adult friend or family member to drive you home afterward.
  • Bring any requested X-ray, CT or MRI images on the day of the procedure.

The injection takes just a few minutes, but extra time is needed to get ready to reduce the risk of infection and safely perform the procedure. During the procedure:

  • Typically, you lie on your stomach. Your back is cleaned and may be covered with sterile towels.
  • Medicine is given to numb the skin near the place of the shot.
  • X-ray imaging (fluoroscopy) is used, and if you are not allergic, a contrast “dye” will be injected to confirm proper placement. This helps your healthcare provider get a better image.
  • A local anesthetic (for numbing), steroids (for reducing inflammation), or both are injected into the epidural space.

You will spend time in a recovery area after the procedure. It is helpful to have a family member or friend drive you home.

After a lumbar epidural injection, you don’t need to stay in bed when you get home. In fact, it’s best to walk around if you feel up to it. Just be careful about being too active. Even if you feel better right away, don't do activities that may strain your back. Follow up on all treatment with your healthcare provider.

Keep in mind that some people feel more pain at first. It usually goes away within a few days. You may also have headaches or trouble sleeping. If these symptoms are severe, you should call your healthcare provider right away. These should also go away within a few days. In general:

  • An injection to reduce inflammation takes a few days to work, and sometimes up to a week. There may even be more pain at first.
  • An injection to help locate the source of pain may give only brief pain relief. Later, you’ll feel the same as you did before the injection.

Call right away if you notice any of the following symptoms:

  • Severe low back pain or headache
  • Loss of bladder or bowel control
  • New onset numbness or weakness
  • Fever Greater than 100°F or chills
  • Redness or swelling around the injection site