Lumbar Epidural Steroid Injections (LESI)

IS A LUMBAR EPIDURAL STEROID INJECTION RIGHT FOR You?

This treatment may be helpful if your back or leg pain is caused by irritation or inflammation around the spinal nerves. Common conditions treated with LESI include herniated discs, degenerative disc disease, spinal stenosis, or a pinched nerve (sometimes called radiculopathy or radiculitis). These conditions can lead to symptoms such as pain that radiates down the legs, as well as numbness, tingling, or muscle weakness.

LESI is often considered when physical therapy, medications, or other conservative treatments haven’t provided enough relief. It can also be a useful option for people who are trying to delay or avoid back surgery.

How Does a Lumbar Epidural Steroid Injection Work?

Your spinal cord runs from your brain down your back and sends out nerves that travel to different parts of your body. These nerves carry signals, including pain, back to your brain. When a nerve in your lower back gets irritated or swollen, often because of a bulging disc or narrowing in the spine, it can cause pain that travels down your leg.

Steroid medicine helps reduce swelling and inflammation. When it’s injected into the space around the irritated nerves (called the epidural space), it goes right to the source of the pain. This can help calm the nerve, reduce pain, and make it easier for you to move and go about your day.

What to Expect During the Procedure

Before your injection, you may be asked to avoid eating or drinking for at least 2 hours. You should continue taking your usual medications, but your provider may ask you to stop blood thinners a few days beforehand.

At the start of the procedure, the skin on your lower back will be numbed with a local anesthetic. With live X-ray guidance (called fluoroscopy), your doctor will gently guide a small needle into the epidural space. A small amount of contrast dye may be injected first to ensure the medication will spread properly. Once everything is in place, your doctor will slowly inject the steroid medication, then remove the needle. A small bandage will be placed over the injection site.

What to Expect After the Injection

Some people feel relief within a few hours, but in most cases, the full effects of the steroid take 24 to 72 hours. For some, it may take up to a week to feel the maximum benefit.

It’s common to need more than one injection to get the best results. Your pain management doctor will help you decide if a repeat injection is appropriate based on how you respond to the first one.

You can usually return to normal activities the next day, but it’s best to take it easy for the rest of the day after your injection. You may feel soreness at the injection site, which should go away within a day or two.

If you have questions about whether a lumbar epidural steroid injection is right for you, our pain management team is here to help guide you through your options.

Follow-Up Care

After your injection, your doctor may schedule a follow-up visit within a few weeks to see how well the treatment is working. If you experience good relief, no further action may be needed right away. If your pain comes back or only improves for a short time, your doctor may recommend another injection.

Most people receive a series of up to three injections over several months, spaced out to allow time for each one to take effect. Your care team will track your progress and adjust the plan based on how you’re feeling.

If your symptoms return or get worse between injections, be sure to let your provider know so they can help you decide on next steps.

Common Questions About Lumbar Epidural Steroid Injections

Will I need to rest after the injection?

We recommend taking it easy for the rest of the day after your injection. You can usually return to normal activities the following day unless your doctor tells you otherwise.

How long does the pain relief last?

Relief varies from person to person. Some people feel better for weeks or even months, while others may need a series of injections to get the best results.

Is the injection painful?

You may feel a pinch or pressure during the procedure, but the area is numbed beforehand to keep you comfortable. Most people describe it as uncomfortable but tolerable.

Are there any side effects I should watch for?

It’s common to have a little soreness at the injection site. Rarely, people may feel flushed, have trouble sleeping, or experience a headache. Serious side effects are very uncommon.

Can this help avoid surgery?

For many individuals, LESI can reduce inflammation enough to delay or avoid back surgery. It doesn’t fix the underlying issue, but it may provide enough relief to help you feel and move better. If you would like to learn more about treatments that may enable you to avoid or delay back surgery, you can review our list here.