Lumbar epidural steroid injection: your FAQ

A wood epidural steroid injection is a treatment to relieve pain in the lower back or legs caused by inflammation of the nerves in the spine.

Steroids, also called corticosteroids, are drugs that reduce inflammation. Your doctor injects into the epidural space around the spinal cord in your lower back.

You may receive a lumbar injection of steroids if you have pain caused by:

  • a herniated disc
  • spinal stenosis
  • degenerative disease of the spine
  • bone spurs

Everyone reacts differently to the procedure. In general, a lumbar epidural steroid injection can be a bit uncomfortable, but it shouldn’t be painful. You can ask your doctor for a mild sedative to relax you before the procedure.

Your doctor will first inject a local anesthetic into the skin on your back to numb the area. The injection may cause a slight burning or tingling sensation.

You will likely feel some pressure as your doctor inserts the needle into the epidural space to inject the steroid medication. If you feel pain, your doctor may give you more local anesthesia to relieve it.

The epidural injection should begin to relieve your back pain within 1 to 3 days. But sometimes it can take up to a week to see an improvement.

This treatment does not cure back pain, although some people get permanent relief. Typically, if you suffer from chronic back pain, the injection may continue to work for 3-6 months or longer.

If the pain comes back, you may need to get injections several times a year. To potentially help prolong the effects of this treatment, you may want to consider:

  • exercise regularly
  • no smoking
  • stay at a healthy weight for your body

Recovery after an epidural steroid injection is usually rapid.

You won’t be able to drive for the rest of the day and will need someone to help you get home after the appointment.

Avoid soaking in a tub, pool, shower, or other water until your doctor tells you that you can resume those activities.

You should be able to resume your usual activities the day after the procedure. But the pain may prevent you from performing more strenuous activities, such as exercise, for a few days.

Your back might be a little sore for a few days after the injection. Holding an ice pack to the area three or four times a day and taking an over-the-counter pain reliever can help.

Epidural steroid injections are generally safe. The most common side effects are mild and may include:

  • injection site pain
  • flushing of the face and chest, called steroid flush
  • sleeping troubles
  • anxiety
  • hot flashes
  • an increase in blood sugar levels
  • fluid accumulation
  • increased back pain
  • headache

These side effects should improve without treatment within 1 or 2 days.

More serious problems are rare but can include:

  • bleeding
  • allergic reaction
  • infection
  • nerve damage
  • numbness or tingling
  • paralysis

Tell your doctor if you still have back pain a few days after the injection. And call your doctor’s office right away if you have more serious side effects, such as bleeding or an allergic reaction. Dial 911 or go to the emergency room if you need emergency care.

Before receiving an epidural steroid injection, discuss the benefits and risks of this treatment with your doctor.

Epidural steroid injections provide temporary – and sometimes permanent – relief from back and leg pain caused by conditions such as a herniated disc or degenerative spinal disease. The results can last several months.

If you receive a steroid injection and your pain does not improve, talk to your doctor. The pain may not be coming from the nerves in your spine.

You may need more tests to determine the cause and another type of treatment to relieve it.

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