Home > Treating Back Pain > Epidurals for Back Pain

Epidurals for Back Pain

By: Jo Johnson - Updated: 15 Oct 2015 | comments*Discuss
Epidural; Anaesthesia; Catheter;

An epidural is a regional anaesthetic delivered through a needle and catheter (a fine tube), into the epidural space by a qualified doctor.

The epidural space, sometimes referred to as the extradural space, is in the spinal canal before the spinal cord, cerebrospinal fluid and duramater. The epidural space contains soft-tissue and veins.

The aims of an epidural are to lower pain sensation, and are most commonly administered during childbirth, pre-operatively to be used as a post-operative pain relief and as anaesthesia for Caesarian section.

When an epidural is used for the management of chronic back pain, the solution injected is a mixture of analgesics and steroids.

It must be performed by an anaesthetist who will feel for the correct space between the vertebrae (made easier by positioning the patient appropriately), and using a sterile technique will administer a local anaesthetic to numb the skin area before inserting a guidance needle/introducer to find the epidural space. When the space is found, a very fine tube is passed and the drugs are injected. The tube can be left in situ and be connected to a machine that will administer the solution at intervals determined by the anaesthetist.

It is usually given in the mid-lumbar or lower back as the spinal cord ends at the 1st lumbar vertebra, under which is the cauda equina, (a bundle of nerves that branch off like a horse’s tail). This area of administration lowers the risk of spinal cord injury.

Indications of Epidural Use for Back Pain

Epidurals, have a 50% success rate, and are useful in the management of back pain caused by herniated discs, degenerative disc disease or for spinal stenosis. In conjunction with an exercise programme results can be a reduction in swelling and lowered irritation to the spinal nerves.

It is a temporary pain relief, which can last from one week to a year, and allows the patient to use the time participating in other rehabilitative therapies.

There is usually need for a course of 3 treatments. Though if the first one is totally unsuccessful and no benefit is gained, there is no cause for continuing with the remainder.

Effects/Side-Effects of an Epidural

The desired effects of an epidural are lowered sensations, lowered pain perception and loss of muscle power (if needed for surgical anaesthesia).

Other side-effects can include a drop in blood pressure, as the epidural causes loss of control of parts of the central nervous system, including that which controls blood pressure, and headaches. ‘Epidural headaches’ are caused when the cerebrospinal fluid leaks out of its space.

The needle or catheter may be misplaced into a vein, not very serious but can cause unnecessary discomfort for the patient.Occasionally, though not very often, the level of block can be a little higher up the spinal column than expected, patients will need to be closely monitored until it has come down to an acceptable level.


  • Epidural should not be given to patients that have bleeding disorders, unless sufficient time has been given to amend existing medications.
  • Epidurals should not be given through sites of infection or broken or bruised skin.
  • Certain conditions such as spina bifida, scoliosis or previous spinal surgery may make administration particularly difficult and may have to be avoided.
Epidurals can be a very effective way of managing chronic back pain. The benefits can allow patients to try other longer-term therapies to improve their chances of being pain free in the future.

You might also like...
Share Your Story, Join the Discussion or Seek Advice..
I have just seen a spinal surgeon, about my back. I have now been off work for 4 months, after an injury. I have L3/4 there is a right paracentral disc protrusion with a substantial caudally migrated disc extrusion effecting the right lateral recess fat where it impinges on the traversing right L4 nerve root. At L4/5 there is a broad posterior protrusion which causes mild narrowing of the exit foramina. At L5/S1 there is a broad posterior disc protrusion which indents the thecal and causes mild narrowing of the exit foramina bilaterally although no impingement of the exiting L5 nerve root is demonstrated. The conus terminates at L3/4 and imaged cord returns normal signal. Conclusion, L3/4 disc extrusion causing right lateral recess stenosis where it on the right L4 nerve root. This is all alien to me, but what he is suggesting is some injections, he said that I would have to go in and put under, because there would be allot of injections, I am still wondering what is going to happen long term, I am not a Doctor, therefore I don't understand all the terminology they use. Would I be able to go back to work, I work in maintenance, and there is lots of lifting bending, crawling and stretching. And when would I be able to go back. Will my condition improve, or are we masking the pain. I'm just so confused. Hope some one can help and explain some of this so I can understand.
trev - 15-Oct-15 @ 5:56 PM
Share Your Story, Join the Discussion or Seek Advice...
(never shown)
(never shown)
(never shown)
(never shown)
Enter word:
Latest Comments
  • Micky
    Re: Ligament Damage and Back Pain
    I had prolapse of rectum op in 2001.he also said he had repaired a ligament.cane home couldn't bare down to open bowels.lost…
    21 April 2017
  • Vis
    Re: Spinal Dislocation
    i have enjoyed the literature.
    17 April 2017
  • KFreedOM
    Re: Dehydrated Discs
    I'm so glad to have read this article about dehydration affecting the disc. It just happened to be something that I was curious about and decided…
    26 December 2016
  • Kal
    Re: Dehydrated Discs
    I was suffering from sciatic pain for nearly 1 year and don't have any idea what is the reason for pain. After 1 year 3 weeks back I went to…
    26 November 2016
  • Skb24 going on 75
    Re: Dehydrated Discs
    I am 24 and i have severe back pain i have a buldging disc in my L1 and L5 almost my entire lower lumbar is dehydrated and i have lost nearly 50%…
    21 November 2016
  • billa
    Re: Dehydrated Discs
    I am 25. My mri result shows I hv got dehydration of L4/5 disc.my doctor advice me to take Diclofenac and hv physiotherapy ,but I Still hv pain…
    16 October 2016
  • Salsybar
    Re: Dehydrated Discs
    Hello all Im a newbie on here ...my long road started 4 years ago I had always been a fitness fanatic..vegetarian and look after myself At the…
    14 October 2016
  • Lorie
    Re: Dehydrated Discs
    All dics on mri are dehydrated with bulging at c4 and c5 also L4 and L5 amd an elongated conus medullaris. I have radiculopathy from neck to…
    7 October 2016
  • madan
    Re: Spinal Dislocation
    My father is 51 his spin has dislocated Lower region due to this he suffer pain on his one whole leg suggests me what should we do
    13 September 2016
  • zane
    Re: Spinal Dislocation
    I can literally see one of the nobs(disks or whatever it's called) on my back that is moved to right of my spine and out of line with the rest…
    25 August 2016
Further Reading...
Our Most Popular...
Add to my Yahoo!
Add to Google
Stumble this
Add to Twitter
Add To Facebook
RSS feed
You should seek independent professional advice before acting upon any information on the BackPainExpert website. Please read our Disclaimer.