Epidural Steroid Injection

What is an Epidural Steroid Injection?

An epidural steroid injection is a medical procedure commonly used to alleviate pain and inflammation in the spine. During the procedure, a mixture of local anesthetic and corticosteroid medication is injected into the epidural space around the spinal cord and spinal nerves. This targeted approach helps reduce inflammation and provides pain relief for conditions such as herniated discs, spinal stenosis, or sciatica. By numbing the affected area and reducing swelling, epidural steroid injections can offer patients significant relief from back and leg pain, enabling them to engage in rehabilitative activities and improve their overall quality of life.

epidural steroid injection

During an epidural steroid injection procedure, the patient typically lies on their stomach or sits on an examination table. The area of the back where the injection will be administered is cleaned and sterilized. To minimize discomfort, a local anesthetic is applied to numb the skin and underlying tissues. Using fluoroscopy (a type of X-ray guidance), the healthcare provider carefully guides a thin needle into the epidural space in the spine. Once the needle is correctly positioned, a combination of corticosteroid medication, which reduces inflammation, and a local anesthetic, which provides temporary pain relief, is injected into the epidural space. The entire procedure usually takes about 15 to 30 minutes. Afterward, patients are monitored for a short period to ensure there are no immediate complications before being allowed to go home. Epidural steroid injections are often performed on an outpatient basis, allowing patients to resume their normal activities shortly after the procedure.

While epidural steroid injections are generally considered safe, like any medical procedure, they do carry some risks. Common risks and potential side effects include temporary pain at the injection site, temporary increase in pain (which can happen before the steroids take effect), infection at the injection site, nerve damage, bleeding, or dural puncture (puncture of the membrane surrounding the spinal cord), which can lead to a headache. Additionally, although rare, some patients might experience an allergic reaction to the medications used. It’s essential for patients to discuss their medical history, allergies, and any concerns with their healthcare provider before undergoing the procedure. Additionally, patients should be aware of the benefits and potential risks associated with epidural steroid injections and make an informed decision in consultation with their healthcare provider.


If an epidural steroid injection does not provide the desired pain relief, there are several possible courses of action that a healthcare provider might consider. The effectiveness of the injection can vary from person to person, and some individuals may not experience significant or lasting relief. If the initial injection does not work, the healthcare provider may recommend trying another injection, adjusting the dosage, or changing the location of the injection.

Alternatively, the healthcare provider might explore other treatment options such as physical therapy, chiropractic care, acupuncture, or different medications to manage the pain. In some cases, if conservative treatments are not effective, more invasive procedures like nerve blocks, radiofrequency ablation, or even surgery might be considered to address the underlying issue causing the pain.

It’s important for patients to maintain open communication with their healthcare providers, reporting any changes in their condition, including the level of pain experienced after the epidural steroid injection. Based on the patient’s response and overall health, the healthcare provider can then determine the most appropriate next steps in managing the pain effectively.

After receiving an epidural steroid injection, it’s advisable to take some precautions to minimize the risk of complications and ensure the effectiveness of the procedure. While specific instructions can vary based on the individual case and the healthcare provider’s recommendations, patients are generally advised to avoid:

  1. Strenuous Activities: It’s typically recommended to avoid heavy lifting, vigorous exercise, and strenuous physical activities for a brief period after the injection. This helps prevent strain on the injection site and allows the body to heal.

  2. Driving: Patients are often advised not to drive for a certain period after the injection, especially if the procedure involved sedation. The effects of sedation can impair judgment and reaction times.

  3. Soaking in Water: Avoid hot tubs, saunas, and swimming pools for a day or two after the injection to minimize the risk of infection at the injection site.

  4. Changing Medications: Patients should not make any changes to their prescribed medications without consulting their healthcare provider, especially pain medications. Adjustments, if necessary, should be made under medical supervision.

  5. Alcohol Consumption: Limit or avoid alcohol consumption, especially if the injection was performed under sedation, to prevent interactions with medications and promote proper healing.

  6. Ignoring Warning Signs: Patients should be vigilant about any unusual symptoms such as increased pain, swelling, redness, or drainage at the injection site, as these could indicate an infection and should be reported to the healthcare provider promptly.

Always follow the specific post-procedure instructions provided by the healthcare provider, as individual cases can vary, and personalized recommendations are essential for a safe and successful recovery after an epidural steroid injection.