If you are suffering from lower back pain or leg pain and are not getting relief with rest, anti-inflammatory medications, or physical therapy, you may be advised to have an epidural steroid injection. This type of pain relief utilizes the epidural space that encompasses the spine and nerve roots. First, a local anesthetic is administered to numb the area. Then a steroid is injected into the epidural space.
Typically, epidural steroid injections are only recommended after medications and physical therapy fail to alleviate pain. At Neurosurgery One, our spine and pain management physicians take an evidence-based approach, utilizing the latest research to make the best recommendations for your condition. We take time to carefully explain all of your pain management options to ensure you’re able to make the best decision for your pain goals.
Epidural steroid injections may be recommended for radiculopathy, sciatica pain, herniated disc, bulging disc, spinal stenosis, or lower back or leg pain. The injections reduce inflammation and improve mobility, allowing you to engage more fully in a physical therapy regimen that can correct the underlying issue causing pain.
FAQs about Epidural Steroid Injections
Continue reading below to learn more about epidural steroid injections, or click to go directly to these subjects:
- How does an epidural steroid injection work?
- Am I can candidate for an epidural steroid injection?
- What are the benefits and risks of an epidural steroid injection?
- What should I consider before having an epidural steroid injection?
- How long does it take for an epidural steroid injection to work?
- How painful is a lumbar epidural steroid injection?
- What should I do after an epidural steroid injection?
Conditions We Treat
How does an epidural steroid injection work?
An epidural steroid injection works by utilizing the epidural space, which is the area around the spine. The steroid medicine can reduce inflammation, pain, and swelling.
At Neurosurgery One, we perform epidural steroid injections in an outpatient setting under sedation. You will be asked to lay on your side or stomach. Your pain management physician starts by applying an anesthetic to numb the area. CT, fluoroscopy, or another type of imaging will used to then guide the epidural steroid injection into a specific area of the epidural space.
Am I can candidate for an epidural steroid injection?
Medications, physical therapy, and conservative treatments are always recommended before an epidural steroid injection. When pain cannot be management effectively with conservative treatments, epidural steroid injections may be recommended for patients experiencing:
What are the benefits and risks of an epidural steroid injection?
Epidural steroid injections are minimally invasive and the actual time it takes for the injection is only a matter of minutes. However, the benefits of epidural steroid injections vary from patient to patient and range from minimal relief to long-lasting pain relief.
Benefits of epidural steroid injections:
- Pain relief, which can range from temporary to long lasting
- Reduction in inflammation
- Increased range of motion, which can allow for physical therapy
- Reduction in medication use
- Identification of the specific origin of pain
- Prolong or eliminate the need for surgery
Risks of epidural steroid injections:
- May only provide temporary or minimal pain relief
- Although rare, infection or injury may occur
- Temporary paralysis to the bladder or bowel nerves
- Bleeding, reactions to medications, and headache are rare but possible
- Exposure to radiation through imaging
- Potential side effects of steroids like nausea, diarrhea, changes to menstrual cycles and flushed face
What should I consider before having an epidural steroid injection?
It’s important that you weigh the benefits and the risks of an epidural steroid injection. You should also be sure to understand the pain relief you might expect with the injection and whether or not additional epidural steroid injections may be necessary.
How long does it take for an epidural steroid injection to work?
While benefits of an epidural steroid injection vary by patient, most people experience pain relief within a few hours or days of the injection. Some studies show that up to 90% of patients who have an epidural steroid injection experience pain relief. However, the pain relief ranges from a week to a year. It may take up to 10 days before you experience pain relief from the injection.
If your pain subsides with an epidural steroid injection, your spine and pain management physician may schedule a follow up injection to ensure continued relief.
How painful is a lumbar epidural steroid injection?
Pain affects everyone differently. An anesthetic is applied prior to the epidural steroid injection, and this may cause some pain. The pain is typically short lived and leads to numbing of the area so the epidural steroid injection can be administered. You may experience some soreness after the procedure, but rarely feel pain.
What should I do after an epidural steroid injection?
Epidural steroid injections are typically performed in an outpatient setting. The procedure itself generally only takes a few minutes, although it can take some time to get the imaging in place. You will be asked to sit or lay for a while after the injection. You will be in recovery for 30-60 minutes after the procedure. You will need someone to drive you home.
Once the anesthetic wears off, you can engage in light activities and resume most normal activities within 24 hours. Your pain may increase in the short term before the steroid fully begins to work.
In general, you can receive up to three steroid injections in a calendar year without risk of long-term steroid side effects.