Lower lumbar epidural steroid injection side effects

Epidural steroid injections are generally very safe, but there are some rare potential complications. One of the most common risks is for the needle to go too deep and cause a hole in the dura, the tissue that surrounds the spinal cord and nerve roots. When this occurs spinal fluid can leak out through the hole and cause a headache . This headache can be treated with bedrest, or with a blood patch. A blood patch involves drawing some blood from the vein and the injecting it over the hole in the dura. The blood forms a seal over the hole and prevents any further fluid from leaking out.

Currently, epidural steroid injections are widely used both in diagnosing and treating neuropathic pain . Lumbar epidural steroid injections, in particular, are performed in the lumbar region of the lower back in order to treat pain that occurs within the lower back and legs. More specifically, corticosteroids are injected into the epidural space surrounding the spinal nerves of the lumbar region. This medication functions to reduce pain and inflammation within the area. The procedure itself is minimally invasive and does not require surgery.

The epidural space lies just outside the special covering or dura, which encloses the spinal canal. An 'epidural' is a type of regional anesthetic in which a needle is positioned between the bones of the spine to allow the anesthesiologist to insert a small plastic tube (or catheter) into the epidural space. The needle is then removed and local anesthetic is injected through the catheter. This local anesthetic moves (or diffuses) across the dura. into the spinal canal, and temporarily stops the spinal nerves from working, so that sensation and movement in the area supplied by the nerves does not occur. When the effect of the local anesthetic wears off, sensation and movement will return. If a weaker solution of local anesthetic is used, then only painful sensations will be blocked.

This is very useful for controlling pain and is called epidural analgesia. Often continuous infusions of local anesthetic solutions are used, which allows the effect to be maintained as long as required. The catheter may be placed in the upper back (thoracic spine) or the lower back (lumbar spine), depending on where the effect is needed. This is a very useful and safe procedure, when performed with appropriate care by an experienced anesthesiologist.



We note these studies not to discourage you from undergoing epidural steroid injections, but rather to help foster well-rounded discussions with your doctor. These injections have been shown to provide excellent pain relief in many patients (particularly those who have had symptoms for less than 3 months, not had a previous spine surgery, are younger than 60 years, and don’t smoke). However, epidural steroid injections are not magic bullets. Before starting injection therapy, talk to your doctor about the specific risks and benefits for you.

The caudal approach to the epidural space involves the use of a Tuohy needle, an intravenous catheter, or a hypodermic needle to puncture the sacrococcygeal membrane . Injecting local anaesthetic at this level can result in analgesia and/or anaesthesia of the perineum and groin areas. The caudal epidural technique is often used in infants and children undergoing surgery involving the groin, pelvis or lower extremities. In this population, caudal epidural analgesia is usually combined with general anaesthesia since most children do not tolerate surgery when regional anaesthesia is employed as the sole modality.

Lower lumbar epidural steroid injection side effects

lower lumbar epidural steroid injection side effects

We note these studies not to discourage you from undergoing epidural steroid injections, but rather to help foster well-rounded discussions with your doctor. These injections have been shown to provide excellent pain relief in many patients (particularly those who have had symptoms for less than 3 months, not had a previous spine surgery, are younger than 60 years, and don’t smoke). However, epidural steroid injections are not magic bullets. Before starting injection therapy, talk to your doctor about the specific risks and benefits for you.

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