Epidural steroid injections are sometimes recommended for treating chronic low back and leg pain. Usually, this treatment is just one component of a comprehensive plan that includes other nonsurgical options, such as physical therapy and oral medications. Many patients do well with this approach, often to the point that surgery becomes unnecessary.

When are injections usually recommended?

In some cases, epidural steroid injections can provide effective — but temporary — relief from two main types of back pain. The first type is radiculopathy, which is characterized by sharp, shooting pains that originate in the lower back and travel down one or both legs, or start in the neck and radiate down one or both arms. Radiculopathy can be caused by spinal nerve compression, which may result from a herniated disc or other degenerative spine condition.

The second type is localized pain in the buttocks or legs, which may be associated with spinal stenosis (narrowing) and other spine conditions. Over time, the spinal canal may become narrower due to age-related changes or ongoing wear and tear. When this limited space becomes overcrowded, sensitive nerve tissue may be pressured.

How do injections work?

Steroids can inhibit the body’s inflammatory response to pain. For treating back pain, epidural steroid injections are used to deliver medications directly into the epidural space in the spine. Typically, these medications include a combination of:

• A fast-acting local anesthetic to temporarily numb the injection site
• Saline to dilute the local anesthetic or serve as a “flushing” agent to dilute the immunologic agents that promote inflammation.
• Cortisone (a steroid) to reduce inflammation

While the effects of epidural steroid injections are not permanent — they may provide relief for one week up to one year — this treatment can be beneficial for a patient who is experiencing an acute episode of neck, back or leg pain. Additionally, an injection may provide enough pain relief to allow a patient to participate in a rehabilitative stretching and exercise program. If an initial injection is effective, a patient can usually have up to three injections in a one-year period.

To learn more, contact your physician.