Epidural Steroid Injection

What is an Epidural Steroid Injection?

An epidural steroid injection is a treatment where a doctor places medicine into the epidural space — the area around the spinal nerves in your back or neck. The injection contains a steroid (to reduce inflammation) and a local anesthetic (to numb the area). It’s often used for back, leg, neck, or arm pain caused by problems like a herniated disc, spinal stenosis, or sciatica.

How do you prepare for an Epidural Steroid Injection?

• Tell your doctor about all medicines you take, especially blood thinners, since you may need to stop them before the procedure.
• Tell your doctor if you had any spinal surgery
• Discuss allergies to steroids, anesthetics, or contrast dye.
• You may be asked to avoid eating or drinking for a few hours before the procedure.
• Wear loose, comfortable clothing.
• Arrange for a ride home, since you may feel numb, weak, or drowsy afterward.

Why is an Epidural Steroid Injection performed?

• To reduce pain and inflammation from irritated spinal nerves.
• To relieve symptoms of conditions like sciatica, herniated discs, arthritis of the spine, or spinal stenosis.
• To improve mobility and function, allowing you to participate more fully in physical therapy.
• Sometimes used to delay or avoid surgery if pain improves enough.

What can you expect during an Epidural Steroid Injection?

• The procedure is usually done in a hospital or ambulatory surgery center and takes about 20–30 minutes.
• You’ll lie on your stomach.
• The skin is cleaned and numbed.
• The doctor uses X-ray guidance (fluoroscopy) to place the needle accurately into the epidural space.
• A small amount of contrast dye may be injected first to confirm placement.
• The steroid and anesthetic medicine are then injected.
• You may feel pressure or mild discomfort during the injection.
• You’ll be monitored for a short time afterward before going home.

What is the follow-up like for an Epidural Steroid Injection?

• You may feel immediate relief from the numbing medicine, but this usually wears off in a few hours.
• The steroid typically starts working in 3-7 days.
• Pain relief may last weeks to months, depending on your condition.
• Your doctor may also recommend physical therapy or exercises to maintain results.

What are the potential risks for an Epidural Steroid Injection?

Most side effects are mild and temporary, such as:

• Soreness or bruising at the injection site.
• Temporary numbness, tingling, or weakness in the arms or legs.
• A “steroid flare” — increased pain for a day or two before it improves.
• Elevated blood sugar (especially those with diabetes).
• Allergic reaction to contrast such as itching or rash

Less common but more serious risks include:

• Infection.
• Bleeding.
• Nerve or spinal cord injury.
• Severe Allergic reaction to contrast dye such as arachnoiditis or anaphylaxis
• Spinal headache.