Dr. Jordan Sudberg Breaks Down LESIs: A Powerful Tool for Managing Chronic Pain in the Lower Back
Chronic lower back pain is one of the most common reasons people seek medical attention, missing work, or struggling to maintain an active lifestyle. In fact, according to the CDC, nearly 40 million adults in the U.S. report having back pain. For many of these individuals, the pain is not just a nuisance—it’s a daily obstacle.
Dr. Jordan Sudberg, a board-certified pain management specialist, has helped countless patients reclaim their lives using a variety of minimally invasive treatments. One of the most effective procedures he frequently recommends for lower back pain is the Lumbar Epidural Steroid Injection, also known as an LESI.
But what exactly is an LESI? How does it work? And who should consider one? In this post, Dr. Sudberg explains the ins and outs of this widely used yet often misunderstood pain relief technique.
What Is an LESI?
A Lumbar Epidural Steroid Injection (LESI) is a non-surgical treatment used to relieve inflammation and pain in the lumbar spine—the lower portion of the back. It involves injecting a corticosteroid medication, sometimes along with a local anesthetic, into the epidural space of the spinal canal.
“LESIs target inflammation directly at its source,” says Dr. Sudberg. “This approach allows us to reduce pain and improve function without resorting to more aggressive interventions like surgery.”
What Conditions Are LESIs Used to Treat?
LESIs are most effective in treating pain that radiates from the lower back into the hips, legs, or feet—what’s often referred to as radicular pain. Common conditions that Dr. Sudberg treats with LESIs include:
- Herniated or bulging discs
- Spinal stenosis (narrowing of the spinal canal)
- Sciatica (compression of the sciatic nerve)
- Degenerative disc disease
- Spondylolisthesis (vertebrae slipping out of place)
- Post-laminectomy syndrome (persistent pain after back surgery)
“Patients who feel shooting or burning pain that travels down one or both legs are ideal candidates,” Dr. Sudberg notes. “This pain pattern suggests nerve root irritation, which LESIs are specifically designed to treat.”
How Do LESIs Work?
The epidural space is the area surrounding the spinal cord and the nerves that exit the spine. When inflammation in this space causes compression or irritation of these nerves, the result is pain, numbness, or weakness that can affect the lower back and legs.
An LESI works by delivering a steroid directly into this space. Steroids are powerful anti-inflammatory agents that can reduce swelling around the nerves, relieve pain, and allow for healing.
“Think of an LESI as a targeted fire extinguisher,” explains Dr. Sudberg. “It puts out the inflammatory fire causing the nerve pain, giving the body time to recover.”
What to Expect During the Procedure
An LESI is a relatively quick outpatient procedure, typically taking 20–30 minutes. Dr. Sudberg walks us through what patients can expect before, during, and after the injection.
Preparation
Patients are advised to avoid eating a heavy meal beforehand and may be asked to stop taking certain medications like blood thinners. A brief consultation and physical exam help confirm that the patient is a good candidate.
During the Procedure
- The patient lies face down on a specialized table.
- A local anesthetic is used to numb the area.
- Using fluoroscopy (a type of real-time X-ray), Dr. Sudberg carefully guides a thin needle into the epidural space.
- Once the needle is confirmed to be in the correct position, the steroid solution is slowly injected.
Patients typically report only mild discomfort during the procedure, often described as pressure or a warm sensation.
Aftercare
Most patients can go home within 30–60 minutes of the procedure. Dr. Sudberg recommends taking it easy for the rest of the day and resuming normal activity the next day.
“Some patients experience immediate relief, while others may feel improvement within a few days to a week,” says Dr. Sudberg. “This varies depending on the severity and cause of the inflammation.”
How Effective Are LESIs?
The effectiveness of LESIs varies, but many patients experience significant pain relief that can last weeks or even months. Relief can make it possible to participate in physical therapy, return to work, or avoid surgery altogether.
In a 2023 review published in Pain Medicine, researchers found that LESIs were effective in providing pain relief in over 70% of patients with lumbar radiculopathy.
“LESIs aren’t a cure, but they are a vital part of a comprehensive treatment plan,” says Dr. Sudberg. “They give patients the window of relief needed to strengthen muscles, improve posture, and regain control.”
How Many Injections Can You Get?
Generally, pain specialists like Dr. Sudberg limit the number of LESIs to three per year to avoid long-term steroid side effects, such as:
- Hormonal imbalances
- Bone thinning
- Blood sugar spikes
- Increased infection risk
“We use LESIs strategically,” Dr. Sudberg explains. “They should be part of a broader pain management plan—not a standalone solution.”
Risks and Side Effects
LESIs are considered safe, especially when performed by experienced specialists like Dr. Sudberg. However, as with any procedure, there are potential risks:
- Temporary increase in pain
- Headache
- Infection
- Bleeding
- Nerve damage (very rare)
- Allergic reaction to the injected medication
To minimize these risks, patients are carefully screened and the procedure is done under strict sterile conditions.
When Should You Consider an LESI?
Dr. Sudberg suggests considering an LESI if:
- You’ve had pain for more than six weeks with no relief from conservative care
- The pain radiates into your legs or buttocks
- Physical therapy or medications are not helping enough
- Imaging (like MRI) confirms a structural issue that aligns with your symptoms
“The sooner we intervene with the right treatment, the better the long-term outcome,” Dr. Sudberg says. “Ignoring chronic inflammation can lead to muscle loss, compensation injuries, and even depression.”
Final Thoughts: LESIs as Part of a Comprehensive Pain Strategy
Lumbar Epidural Steroid Injections are not a one-size-fits-all cure, but when used thoughtfully, they can dramatically improve quality of life for those suffering from chronic lower back pain. Whether you’re trying to avoid surgery or need a break from daily discomfort, LESIs offer a safe and effective bridge to recovery.
Dr. Jordan Sudberg believes in personalized, multidisciplinary pain management. That means LESIs aren’t used in isolation, but alongside therapies like exercise, ergonomic education, and, when needed, regenerative medicine.
“Managing pain is about more than numbing symptoms—it’s about restoring function and empowering patients,” Dr. Sudberg concludes. “LESIs are one of the tools we use to help people get their lives back.”