Lumbar transformational epidural steroid injections are performed to relieve lower back and leg pain.
The steroid medication can reduce swelling and inflammation caused by spinal conditions such as spinal stenosis, radiculopathy, sciatica, and herniated discs. The patient lies face down. A cushion is placed under the stomach area to provide comfort and flex the back.
This position causes the spine to pull to facilitate access to the epidural space. The doctor uses a fluoroscope to locate the appropriate lumbar vertebra and nerve root, and a local anesthetic numbs the skin. All tissue up to the surface of the vertebral transverse process is anesthetized. The doctor slides a thin, bent needle with a slightly curved tip through the anesthetized line.
With the help of a fluoroscope, the doctor carefully guides the needle into the foraminal space near the nerve root. The doctor injects a contrast solution and uses the fluoroscope to see the painful areas and confirm the correct location of the needle tip. An anesthetic mixture of steroids is injected into the foraminal epidural space bathing the painful nerve root with a calming medication. the needle is withdrawn and a small band-aid is used to cover the small wound on the surface of the needle. In some cases, it may be necessary to repeat the procedure up to 3 times to obtain the full benefits of the drug. However, many patients feel significant relief after just one or two injections.
Additional pain management options can be extremely beneficial in conjunction with epidural injections. These may include physical therapy, chiropractic, spinal decompression, and pain relievers.