A Lumbar Epidural Steroid Injection (LESI) is a common medical procedure designed to deliver an anti-inflammatory steroid and local anesthetic directly into the epidural space of the spine. The primary objective of this injection is to reduce inflammation and alleviate pain that radiates from the lower back into the legs, often caused by nerve root compression. Following the procedure, a structured period of rest is necessary to maximize the therapeutic effect of the medication and significantly reduce the potential for complications.
Immediate Post-Injection Observation Period
Immediately after the injection, patients are moved to a recovery area for a mandatory observation period, typically lasting between 15 minutes and two hours. This initial rest is necessary because the local anesthetic component can temporarily affect nerve function. Medical staff monitor for immediate side effects, such as a drop in blood pressure, dizziness, or temporary numbness or weakness in the legs.
The local anesthetic often provides immediate pain relief, but its effects wear off within a few hours, and the original pain may return temporarily. Due to residual effects from the anesthetic or any mild sedation, driving is prohibited for the remainder of the day. A responsible adult must escort the patient home following discharge to ensure safety.
Activity Restrictions for the First 24 Hours
The first 24 hours following the procedure are the most restrictive, focusing on protecting the injection site and allowing the medication to settle. During this period, patients must avoid any activities that place undue stress on the lumbar spine. This includes refraining from operating heavy machinery, signing legal documents, or making significant decisions until the day after the injection.
Lifting restrictions are enforced; patients should not lift anything heavier than 5 to 10 pounds. This limitation minimizes strain on the lower back muscles and prevents increased pressure within the epidural space. Showering is permitted, but patients must avoid soaking the injection site, meaning no baths, hot tubs, or swimming for at least 24 to 48 hours to prevent infection. Light walking is encouraged to promote circulation, but prolonged sitting or standing should be limited to 10 to 20 minutes at a time to keep pressure off the spine.
Resuming Exercise and Strenuous Activities
After the initial 24 hours, most patients can gradually reintroduce their normal daily activities. Resuming light duty work or typical household tasks is usually appropriate the day following the procedure, provided the patient feels comfortable and stable. A cautious approach is necessary for activities that significantly stress the spine, such as heavy weight lifting, running, or high-impact sports.
For strenuous exercise, the recommended waiting period ranges from 48 to 72 hours, though some physicians advise waiting a full week or more. The goal is a gradual return to activity, starting with low-impact options like walking, stationary cycling, or gentle stretching. If the injection was intended to facilitate physical therapy, sessions may resume approximately one week after the procedure, allowing the steroid time to begin reducing nerve root inflammation. Patients must listen closely to their bodies and immediately stop any movement that causes a new or increased level of back or leg pain.
Monitoring Symptoms and When to Seek Medical Attention
While soreness at the injection site or a temporary increase in pain is common, certain symptoms require immediate medical attention. Patients should watch for signs of infection, including a fever above 100.4 degrees Fahrenheit, shaking chills, or excessive redness, swelling, or drainage at the injection site. These symptoms indicate a serious complication and require prompt evaluation.
A severe positional headache that worsens when sitting up but improves when lying flat could indicate a dural puncture. Any new or worsening neurological symptoms are also concerning. Patients should contact their provider immediately if they experience new numbness or weakness in the legs, or any sudden loss of control over bowel or bladder function.