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Summary
Epidural injections of local anesthetic or a corticosteroid are frequently given to diagnose and treat patients with radicular pain originating from any spinal level. The best-quality evidence supports a transforaminal approach in the lumbar spine. Many patients experience substantial benefit from a single therapeutic injection. Depending upon the benefit obtained, additional injections may be administered. Selective nerve blocks with local anesthetic alone can identify the spinal nerve mediating the patient's pain. Serious short-term risks are rare but occur; long-term risks are infrequent and can be due to systemic effects of multiple corticosteroid injections. Patients who have failed conservative therapy or are not candidates for surgical intervention can be considered for epidural steroid injections to relieve their radicular pain temporarily.
Footnotes
Funding information and disclosures are provided at the end of the article. Full disclosure form information provided by the authors is available with the full text of this article at Neurology.org/cp.
- © 2014 American Academy of Neurology
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