Epidural Steroid Injection: What to Expect

By the GSMC pain management team, medically reviewed by Dharam P. Mann, MD

If your doctor has suggested an epidural steroid injection for back, neck or leg pain, it is normal to have questions. This guide explains what happens before, during and after the visit, what recovery looks like, the risks, and how long relief may last.

This is Day 4 of our spine and sciatica series. Day 3 covered spinal stenosis treatment without surgery.

What is an epidural steroid injection?

An epidural steroid injection places a small amount of anti-inflammatory steroid, often with numbing medicine, into the epidural space around irritated spinal nerves. It is commonly used for sciatica, a herniated disc and spinal stenosis. The goal is to calm inflammation so pain eases and you can move and do physical therapy more comfortably.

Before the injection

• We review your history, exam and imaging to choose the right level and approach.
• Tell us if you take blood thinners, have diabetes, have an allergy to contrast dye or numbing medicine, or might be pregnant. Do not stop any medicine on your own; we will give you instructions.
• Let us know if you have a fever or infection, since the injection may need to wait.
• Plan for a driver, especially if you receive light sedation, and wear comfortable clothes.

During the injection

• You lie on your stomach or side. The skin is cleaned and numbed.
• Using live X-ray (fluoroscopy) guidance, a thin needle is guided to the epidural space. A small amount of contrast dye confirms the position.
• The medicine is injected. You may feel pressure or a brief increase in your usual pain.
• The injection itself usually takes about 15 to 30 minutes, and the whole visit takes longer with check-in and monitoring.

After the injection and recovery

• You rest for a short time while we check on you, then go home the same day.
• Your back or leg may feel numb or heavy for a few hours from the numbing medicine. Rest the day of your injection.
• Many people return to normal activity and work the next day. Ask us if your job involves heavy lifting.
• Ice on the site for 15 to 20 minutes may ease soreness. Keep a pain diary for about 2 weeks to share with us.
• If you have diabetes, check your blood sugar more often for a few days, since the steroid can raise it.

How long does relief last?

It varies from person to person. The steroid often takes a few days to start working, and some people take longer to notice a change. Some people have relief for weeks to months, while others have little benefit. Injections are usually limited to a few per year, and we review your response before suggesting another one. Many patients use the relief window to make progress in physical therapy.

Risks

Every procedure has risks. Common ones include soreness at the injection site, a short-term increase in pain, flushing, trouble sleeping and a rise in blood sugar. Less common risks include infection, bleeding and a headache from a spinal fluid leak. Allergic reaction and nerve injury are rare. Very rarely, serious problems such as bleeding near the spinal cord can occur. Our team will go over your specific risks before the injection.

Call us right away if you have fever or chills, redness or drainage at the site, pain that is much worse than before, new weakness or numbness, or a bad headache that is worse when you sit or stand. Call 911 for trouble breathing, chest pain, or loss of bladder or bowel control.

Epidural steroid injections at GSMC

Our team evaluates back, neck and leg pain at all 7 GSMC offices in Ocean and Monmouth County: Whiting, Toms River, Brick, Barnegat, Manahawkin, Freehold and West Long Branch. Call to confirm which office offers injections for your visit. Many plans, including Medicare, cover epidural steroid injections when criteria are met, and we verify your benefits before scheduling. If injections do not help enough, other options are covered on our spinal stenosis page and in our Day 3 guide.

Call 732-202-3000 or request a consultation.

Frequently Asked Questions

Does an epidural steroid injection hurt?

The skin is numbed first. Many people feel pressure and brief discomfort. Some people choose light sedation if it is available and appropriate.

How long does an epidural steroid injection last?

It varies. Some people have relief for weeks to months, and others have little benefit. We review your response before suggesting another injection.

How soon will I feel better after an epidural?

The numbing medicine can give short-term relief, and the steroid often takes a few days to start working. Some people take longer to notice a change.

Can I drive after an epidural steroid injection?

Plan to have someone drive you home, especially if you receive sedation.

How many epidural injections can I have?

Steroid injections are usually limited to a few per year to lower the risk of side effects. Your physician will advise you based on your health.

Medical disclaimer: This article is for general education only and is not medical advice. Please talk with your own doctor about your symptoms and treatment. Individual results vary.