FACT SHEETS
Intralaminar Epidural
Intralaminar epidural injections are diagnostic and/or therapeutic procedures for pain originating from spinal nerves and surrounding structures. The procedure consists of injecting local anesthetic and anti-inflammatory medication (usually a corticosteroid) into the epidural space through the space between vertebral laminae.
If the patient experiences significant pain relief while the medication is active, this suggests that inflammation around the spinal nerves is the source of pain. This confirms the diagnosis and provides therapeutic benefit simultaneously.
This injection procedure targets the epidural space where irritated nerve roots are located, delivering medication directly to the site of inflammation. The intralaminar approach specifically refers to entering the epidural space between the bony laminae of adjacent vertebrae.
Should an intralaminar epidural injection provide significant but temporary pain relief, repeated injections may be recommended, typically limited to three to four times yearly. For some patients, this may be followed by other interventions such as physical therapy, rehabilitation exercises, or consideration of surgical options if conservative treatments fail to provide adequate long-term relief.
THE DIAGNOSIS OF INTRALAMINAR EPIDURAL INJECTIONS
Spinal pain commonly manifests as neck, mid-back, or low back pain with or without radiating pain into the arms or legs. Compression or irritation of spinal nerves can result from disc herniations, spinal stenosis, or post-surgical scarring, and these conditions are often visible on imaging studies such as MRI scans.
To target inflammation around spinal nerves, we inject a combination of local anesthetic and anti-inflammatory medication (usually a corticosteroid) into the epidural space. We access this space through the gap between adjacent vertebral laminae—this is why these injections are called intralaminar epidural injections.
Research indicates that epidural injections can provide significant pain relief for patients with radicular pain due to disc herniations and spinal stenosis. The duration of relief varies between patients, with some experiencing long-term benefits while others may require repeated injections.
For persistent radicular pain, intralaminar epidural injections can be used as part of a comprehensive treatment plan that may include physical therapy, medication management, and in some cases, surgical consultation if conservative treatments fail to provide adequate relief.
INJECTION PROTOCOL
The primary purpose of the injection is to reduce inflammation and alleviate pain. Consequently, implementing a consistent pain measurement method is essential. The Visual Analog Scale (VAS) is commonly used, rating pain from 0 to 10—where 0 represents no pain and 10 indicates extreme pain that completely inhibits thinking, movement, and normal functioning.
Patients should continue their regular medication schedule prior to the procedure, except for blood thinners which may need to be temporarily discontinued (only after consultation with your physician). For the procedure to be appropriately evaluated, patients should keep track of their pain levels before and after the injection.
THE PROCEDURE
The injection requires inserting a needle through the skin under fluoroscopic (X-ray) guidance. The needle is carefully guided between the vertebral laminae to access the epidural space. Contrast dye is typically used to confirm proper placement before the medication is injected.
It's perfectly normal to feel anxious about the procedure. However, you can be reassured that these injections are performed routinely, generally involve minimal discomfort due to local anesthetic use, and usually take less than 30 minutes to complete. Some temporary numbness, weakness, or increased pain may occur after the procedure, but these effects typically resolve within hours.