Key Takeaways

• Lumbar spinal stenosis is a narrowing of the lower spinal canal that puts pressure on nearby nerves, causing pain, numbness, or weakness in the back, buttocks, or legs.
• An epidural steroid injection (ESI) delivers medication to reduce inflammation around irritated nerves; it treats symptoms but doesn’t remove tissue causing the narrowing.
• The MILD procedure (minimally invasive lumbar decompression) removes small amounts of tissue or bone, often thickened ligamentum flavum, to physically create more space in the spinal canal.
• ESI is used for a broader range of conditions causing radiating nerve pain; MILD specifically targets stenosis caused by ligamentum flavum thickening.
• Neither treatment is universally “better,” the right option depends on symptoms, imaging, severity, and treatment history.
• Comprehensive Pain Institute evaluates each patient individually at their Bedford, Benbrook, and Flower Mound, TX locations.

 

Going through life with lumbar spinal stenosis makes simple, everyday activities harder than they should be. Things like going to the store, standing in line for a long time, or even just taking an afternoon walk around your neighborhood can come with pain, numbness, and feeling weak.

If you’ve tried treatments in the past that haven’t left you with any relief, your doctor may recommend the MILD procedure or an epidural steroid injection. Both can be used during lumbar spinal stenosis treatment, but they work in very different ways. When you understand those differences, it can make it easier to know what questions to ask your doctor. Our team at the Comprehensive Pain Institute is here to help walk you through your options.

 

What Is Lumbar Spinal Stenosis?

Lumbar spinal stenosis happens when the space inside the lower portion of your spinal canal becomes narrower. This can put pressure on nearby nerves and lead to symptoms in the lower back, buttocks, or legs.

There are several possible causes of spinal narrowing, with one being the thickening of the ligamentum flavum, a ligament located along the spinal canal. When this tissue becomes enlarged, it can take up additional space and add to nerve compression.

 

What Is an Epidural Steroid Injection?

An epidural steroid injection, or ESI, places medication into the epidural space around the spinal nerves. The goal of this procedure is to reduce inflammation and calm the irritated nerves that may be contributing to your pain. At Comprehensive Pain Institute, our pain management doctors often use epidural steroid injections for nerve pain related to spinal stenosis or a herniated disc. An epidural injection may be considered when you’re experiencing:

• Lower back pain that travels into the leg
• Numbness or tingling
• Pain that is related to an irritated/compressed nerve
• Trouble staying active because of your nerve pain

The amount and length of relief depends on the person. An epidural steroid injection focuses on reducing inflammation around irritated nerves, but it doesn’t physically create more space inside the spinal canal.

 

How Is the MILD Procedure Different?

MILD stands for minimally invasive lumbar decompression. Instead of treating inflammation alone, the MILD procedure is designed to focus on a specific source of spinal canal narrowing. Most of the time it’s for patients whose lumbar spinal stenosis is partly caused by a thickened ligamentum flavum. During the procedure:

• Imaging is used to guide specialized instruments to the treatment area
• Small portions of excess tissue and bone are removed (this helps create room in the spinal canal and reduce pressure on the nerves)
• It’s performed through a small opening
• No implant is placed in the spine

 

MILD vs. Epidural Steroid Injection

The biggest difference comes down to each treatment’s goal. 

An epidural steroid injection:

• Places medication around irritated spinal nerves
• Focuses on reducing inflammation and pain
• Doesn’t remove tissue that’s narrowing the spinal canal
• Is an option for several conditions that cause radiating nerve pain

The MILD procedure:

• Is a minimally invasive decompression procedure
• Removes small amounts of tissue contributing to spinal canal narrowing
• Specifically targets thickened ligamentum flavum
• Is generally considered for certain patients with lumbar spinal stenosis and neurogenic claudication

 

Which Treatment Could Be Right for You?

Choosing between an epidural steroid injection and the MILD procedure starts with figuring out what’s causing your symptoms. Our team will consider your:

• Symptoms
• How long you’ve been experiencing your symptoms
• Physical exam
• MRI/imaging
• Location and severity of the spinal narrowing
• Treatments you’ve tried in the past
• Medical history
• Current health

Some patients may benefit from an epidural injection, and others with a specific type of spinal stenosis may be candidates for MILD or another treatment altogether.

 

Finding Pain Management in Bedford, Benbrook or Flower Mound, TX

This probably sounds like a lot of information thrown at you, and you’re still sitting here deciding which could be right for you. And we are here to tell you that you don’t have to figure it out alone! If your back or leg pain is making it harder to live life in general, our team of pain management specialists is here to help.

At Comprehensive Pain Institute, we offer several different options for pain management in Bedford, Benbrook & Flower Mound, TX, including epidural injections and other interventional pain treatments. Our goal is to understand the source of your symptoms and build a treatment plan around your individual needs. Schedule an appointment with us today at the Comprehensive Pain Institute and learn more about your options for lumbar spinal stenosis.

Flower Mound, TX: 4101 Kirkpatrick Ln. Flower Mound, TX. P: 972-436-7531
Bedford, TX: 1305 Airport Fwy. Suite 302B. Bedford, TX 76021. P: 817-786-8238
Benbrook, TX: 9239 Vista Way, Benbrook, TX 76126. P: 817-737-3331

 

Frequently Asked Questions

Q: What is the difference between the MILD procedure and an epidural steroid injection?
A: An epidural steroid injection reduces inflammation by placing medication around irritated spinal nerves, but it doesn’t change the structure of the spinal canal. The MILD procedure is a minimally invasive decompression treatment that removes small amounts of tissue or bone to physically create more space and relieve nerve pressure.

Q: What causes lumbar spinal stenosis?
A: Lumbar spinal stenosis is caused by narrowing of the lower spinal canal, which can result from several factors, including thickening of the ligamentum flavum, a ligament that runs along the spinal canal.

Q: Who is a candidate for the MILD procedure?
A: The MILD procedure is generally considered for patients with lumbar spinal stenosis caused in part by a thickened ligamentum flavum, particularly those experiencing neurogenic claudication (leg pain or weakness triggered by walking or standing).

Q: Does an epidural steroid injection fix spinal stenosis?
A: No. An epidural steroid injection reduces inflammation and calms irritated nerves, which can relieve pain and improve function, but it doesn’t remove tissue or physically widen the spinal canal.

Q: Is the MILD procedure surgery?
A: MILD is a minimally invasive procedure performed through a small opening using imaging guidance. No implant is placed in the spine, and it’s typically an outpatient treatment rather than traditional open spine surgery.

Q: How long does relief from an epidural steroid injection last?
A: The amount and duration of relief varies by person and depends on the underlying cause of the pain. Some patients experience significant, lasting relief, while others may need repeat injections or additional treatment.

Q: How do doctors decide between MILD and an epidural steroid injection?
A: The choice depends on factors like your symptoms, how long you’ve had them, physical exam findings, MRI/imaging results, the location and severity of spinal narrowing, prior treatments, and overall health history.

Q: Where can I find treatment for lumbar spinal stenosis near Bedford, Benbrook, or Flower Mound, TX?
A: Comprehensive Pain Institute offers individualized lumbar spinal stenosis treatment, including epidural steroid injections and the MILD procedure, at their Flower Mound, Bedford, and Benbrook, TX locations.