Lumbar/cervical epidurals are administered primarily for pain relief and inflammation control but these are also used as diagnostic tools. Keep in mind that these procedures are not administered as a cure-all for the treatment of illnesses and injuries to the lumbar and cervical vertebrae but as part of a comprehensive rehabilitation program.
What Is It?
Epidural injections are administered into the epidural space, the space surrounding the nerve roots and spinal cord, with the use of x-ray guidance technology. The injection solutions are not injected into the thecal sac containing the spinal cord and nerve roots, thus, minimizing side effects and health risks.
The injection solutions for both lumbar/cervical epidurals usually consist of:
- Either a steroid or cortisone as an anti-inflammatory agent, which will lessen inflammation and provide pain relief
- Lidocaine as a local anesthetic and as a flushing agent and
- Saline to dilute the substances particularly the local anesthetic
The procedure is performed on an outpatient basis. You can go home and resume normal activities within the day although certain precautions must obviously be made to achieve the best results.
Who Should Consider It?
Both cervical and lumbar epidurals are administered for the relief of severe acute and chronic low back, leg and neck pain, as the case may be. Such pain symptoms are usually the result of one of the following medical conditions:
- Lumbar disc herniation where the disc nucleus pushes through the annulus (outer ring) and into the spinal canal, which then results in pressure on the nerves and spinal cord.
- Degenerative disc disease wherein collapsing disc space impinges on the nerves
- Lumbar spinal stenosis involving narrowing down of the spinal canal
- Compression fractures
- Cysts on either the nerve root or the facet joint
- Tears on the outer layer of the disc
Ask your doctor whether epidurals will be beneficial in your case.
How Is It Done?
In cervical and lumbar epidurals, you will be asked to change into a clean hospital gown to allow your doctor easy, fast and convenient access to the injection area. You will then undergo the following process:
- Lie either flat or on your side on an x-ray table. You may also be allowed to sit up if lying down causes pain
- The injection area is sterilized and numbed with a local anesthetic
- The injection needle is guided into place using fluoroscopy (live x-ray) technology, which minimizes errors in injection
- The contrast dye is injected to confirm the location of the needle
- The epidural steroid solution is injected. You may feel a slight pressure upon injection but this is not painful
You will be monitored for 15 to 20 minutes after the injection procedure. If there are no problems, then you will be discharged along with instructions on appropriate home care measures.
What Should Be Done After It?
You may feel tenderness at the injection site for a few hours; relief is possible by applying an ice pack for 10-15 minutes every hour. You should also rest for the remainder of the day while normal activities may be resumed on the following day.
Lumbar/cervical epidurals should be done by qualified doctors for obvious reasons.