Healthcare providers use lumbar epidural steroid injections (ESIs) as a pain relief option for certain causes of chronic low back pain. They inject an anti-inflammatory medication into the epidural space around your spinal nerves. Lumbar ESIs are most effective in providing pain relief from a herniated disk and spinal stenosis.
A lumbar epidural steroid injection (lumbar ESI) is an injection of anti-inflammatory medicine — a steroid or corticosteroid — into the epidural space around the spinal nerves in your low back. The main goal of lumbar epidural steroid injections is to manage chronic pain caused by irritation and inflammation of the spinal nerve roots in your low back (the lumbar region of your spine) due to certain conditions or injuries. This type of chronic pain is called lumbar radiculopathy (radicular pain), which can radiate down from your low back to your hips, legs and/or feet.
Healthcare providers may recommend lumbar epidural steroid injections for chronic pain management. Your provider injects a steroid or corticosteroid medication into the epidural space by your spinal cord in your low back.
The lower back region of your spine is called the lumbar spine. This region is made up of five vertebrae, and these vertebrae are the largest of the other vertebrae in your spine. They extend from your lower thoracic spine (chest) to your sacrum (the bottom of your spine).
Your vertebrae are the 33 individual, interlocking bones that form your spinal column, which runs from the base of your brain to your tailbone. These bones help protect your spinal cord from injury while allowing you to twist and turn. Between the vertebral bones are disks that provide cushioning for your vertebrae and flexibility for you.
The five vertebrae in your lumbar spine are named lumbar 1 (L1) through lumbar 5 (L5) from top to bottom. The lumbar vertebrae have several important roles, including:
- Supporting and stabilizing your upper body.
- Allowing twisting and bending movements.
- Protecting your spinal cord and cauda equina (the nerves that descend from the bottom of your spinal cord).
- During a lumbar epidural steroid injection procedure, your provider injects a steroid into the epidural space around your spinal cord. The epidural space surrounds your spinal cord like a sleeve and contains fat, spinal nerves, blood vessels and connective tissue. The steroid acts on the irritated nerve(s) that are causing your pain and reduces swelling and pressure on the nerves.
- Lumbar epidural steroid injections most often lead to temporary pain relief that lasts for three months or more, but some people may experience less or no pain relief from the injection.
