Lumbar Epidural Steroid Injection in Cincinnati - APSI Wellness
Learn about lumbar epidural steroid injections for lower back and leg pain. Expert treatment at APSI Wellness in Cincinnati.
Lumbar Epidural Steroid Injection — Lumbar epidural steroid injections deliver anti-inflammatory medication directly into the epidural space of the lower spine to reduce pain and inflammation from compressed or irritated nerve roots.
What Is a Lumbar Epidural Steroid Injection?
A lumbar epidural steroid injection (LESI) is one of the most commonly performed interventional pain procedures. It involves injecting corticosteroid medication and local anesthetic into the epidural space of the lumbar (lower) spine. The epidural space surrounds the spinal cord and nerve roots, and delivering medication directly to this area allows targeted treatment of inflammation and pain at its source.
This procedure is a cornerstone of interventional pain management and has helped millions of patients find relief from lower back and leg pain.
How Does It Work?
When spinal structures like herniated discs, bone spurs, or thickened ligaments compress or irritate lumbar nerve roots, they cause inflammation that generates pain. This pain often radiates from the lower back into the buttock, hip, and down the leg (sciatica).
The epidural steroid injection works by:
Reducing inflammation: The corticosteroid is a powerful anti-inflammatory that decreases swelling around the compressed nerve roots
Pain interruption: Local anesthetic temporarily blocks pain signal transmission
Promoting healing: By reducing inflammation, the injection creates an environment where irritated nerves can begin to heal
Types of Lumbar Epidural Injections
There are three main approaches to lumbar epidural injections:
Interlaminar: The needle is placed between the laminae (bony arches) of the vertebrae into the epidural space. This is the traditional approach.
Transforaminal: The needle is placed through the neural foramen (the opening where the nerve root exits the spine), delivering medication directly to the affected nerve root. This is the most targeted approach.
Caudal: The needle enters through the sacral hiatus at the base of the spine. This approach is covered in its own service page.
Your physician will select the best approach based on your specific condition and anatomy.
Conditions Treated
Herniated or bulging discs — disc material compressing nearby nerve roots
Sciatica — radiating leg pain caused by lumbar nerve root compression
Lumbar spinal stenosis — narrowing of the spinal canal causing nerve compression
Degenerative disc disease — age-related disc breakdown with associated inflammation
Spondylolisthesis — forward slippage of one vertebra over another
Post-surgical pain — persistent pain after lumbar spine surgery
What to Expect During the Procedure
Before: You may need to stop blood-thinning medications. Arrive with a driver as you cannot drive yourself home afterward.
During: You'll be positioned face-down on a fluoroscopy table. The skin is cleaned and numbed with local anesthetic. Using real-time X-ray guidance, the physician guides a thin needle into the epidural space. Contrast dye is injected to confirm proper placement and medication flow. The steroid and anesthetic mixture is then slowly delivered. The procedure takes approximately 15-30 minutes.
After: You'll rest in a recovery area for 15-30 minutes. Temporary leg weakness or numbness from the local anesthetic may occur and resolves within hours. Most patients can return to light activities the next day. Avoid strenuous activity for 48 hours.
Benefits
Provides targeted anti-inflammatory treatment directly at the pain source
Minimally invasive outpatient procedure
Can provide weeks to months of significant pain relief
Helps patients participate more fully in physical therapy
May delay or prevent the need for surgery
Quick recovery with minimal downtime
Risks and Side Effects
Temporary increase in pain or soreness at the injection site
Temporary leg numbness or weakness (from local anesthetic)
Headache (rare, from accidental dural puncture)
Facial flushing or temporary blood sugar elevation (from steroids)
Infection, bleeding, or nerve injury (very rare)
Frequently Asked Questions
How long does relief last from a lumbar epidural steroid injection?
Results vary significantly. Some patients experience relief for several weeks, while others benefit for several months. The injection often works best as part of a comprehensive treatment plan that includes physical therapy.
How many injections can I have?
Most physicians recommend no more than 3-4 epidural steroid injections within a 12-month period to minimize cumulative steroid effects.
Will the injection cure my back problem?
Epidural steroid injections treat the symptoms (pain and inflammation) rather than the underlying structural cause. They are designed to provide a window of pain relief that allows you to pursue physical therapy and other treatments that address the root cause.
When will I feel the effects?
The local anesthetic may provide immediate but temporary relief. The steroid component typically takes 3-7 days to reach full effect. Some patients notice gradual improvement over 1-2 weeks.
Is this the same as a "cortisone shot"?
The concept is similar — both deliver corticosteroid medication to reduce inflammation. However, an epidural steroid injection is a highly precise procedure using fluoroscopic guidance to place medication in the epidural space, while a typical cortisone shot may be injected into a joint, muscle, or tendon without imaging guidance.
Can I have this procedure if I'm on blood thinners?
Blood-thinning medications typically need to be stopped before the procedure. Your physician will provide specific instructions about which medications to hold and for how long based on the type of blood thinner and your overall medical situation.
APSI Wellness — Advanced Pain Solutions & Interventions
5405 DuPont Circle Suite A, Milford, OH 45150 | Phone: (513) 936-3050
https://apsiwellness.com/services/lumbar-epidural-steroid-injection