Everything You Need to Know About Epidural Steroid Injections

Epidural steroid injections (ESIs) are one of the most commonly performed procedures in interventional pain management. They are frequently used to treat neck, back, and radiating nerve pain caused by conditions such as herniated discs, spinal stenosis, and sciatica.

Despite being widely used, many patients feel uncertain or anxious before their first injection. Questions about safety, effectiveness, and what the procedure actually involves are extremely common.

At Groth Pain and Spine, we believe that informed patients experience better outcomes. So, this guide explains what epidural steroid injections are, how they work, what to expect during the procedure, and who benefits most from them.

What Is an Epidural Steroid Injection?

An epidural steroid injection involves placing steroid medication into the space around the spinal nerves to help reduce swelling and relieve pain. This injection reduces inflammation around irritated or compressed nerves, which is often the primary source of pain.

The injection usually contains -

• A corticosteroid (anti-inflammatory medication) 

• A local anesthetic (for immediate pain relief in some cases) 

How Do Epidural Steroid Injections Work?

Many spinal conditions cause pain because of inflammation of nerve roots, and not because of mechanical compression. When a disc herniates or spinal stenosis develops, inflammatory chemicals irritate nearby nerves, leading to pain, numbness, or tingling. ESIs work by -

• Reducing inflammation around nerve roots 

• Decreasing chemical irritation 

• Interrupting pain signaling pathways 

• Allowing improved participation in physical therapy 

While the injection does not “fix” a herniated disc or stenosis, it can reduce your symptoms and improve your function during the healing process.

Conditions Treated With Epidural Steroid Injections

ESIs are commonly used to treat -

Lumbar Spine Conditions

• Herniated discs 

• Sciatica (radicular leg pain) 

• Spinal stenosis 

• Degenerative disc disease 

Cervical Spine Conditions

• Cervical radiculopathy (arm pain) 

• Herniated cervical discs 

• Foraminal stenosis 

Less Common Indications

• Post-surgical nerve inflammation 

• Chronic radicular pain syndromes 

What are the Types of Epidural Steroid Injections?

There are three main approaches, depending on the location and cause of pain -

1. Interlaminar Epidural Injection

2. Medication is placed into the posterior epidural space 

3. Often used for widespread or central pain 

4. Common in the lumbar and cervical regions 

2. Transforaminal Epidural Injection

3. Targets a specific nerve root 

4. Often used for unilateral radicular pain (e.g., sciatica) 

5. Allows for more precise delivery of medication 

3. Caudal Epidural Injection

4. Accessed through the sacral hiatus 

5. Used when other approaches are difficult or in post-surgical cases

6. Often used for multilevel pathology 

What Happens During the Procedure?

Epidural steroid injections are usually performed in an outpatient setting and take about 5 to 10 minutes.

Step-by-step process 

1. Preparation 

   1. The patient is positioned on a procedure table, lying face down

   2. Vital signs are monitored 

2. Sterile Technique 

   1. The skin is cleaned and sterilized 

   2. A local anesthetic is used to numb the skin 

3. Fluoroscopic Guidance 

   1. X-ray guidance (fluoroscopy) is used to ensure precise needle placement 

   2. The doctor usually injects contrast dye to confirm proper spread of the medication within the epidural space. 

4. Medication Injection 

   1. The doctor slowly injects the steroid medication into the epidural space. 

5. Recovery 

   1. The care team observes the patient for a short time before they go home. 

Does an Epidural Injection Hurt?

Patients often say that the procedure involves mild discomfort and does not cause a lot of pain. You might feel -

• Pressure during needle placement 

• Mild burning from the local anesthetic 

• Temporary worsening of nerve symptoms during the injection 

Most patients tolerate the procedure well, especially when doctors use local anesthetics and careful techniques.

Call 631-543-1440 & Ask Us Your Questions About Epidural Steroid Injections

How Long Does an Epidural Injection Take to Work?

The response to an epidural steroid injection varies -

• Some patients feel relief within 24 to 72 hours 

• Others usually take 5 to 7 days to notice improvement 

• In some cases, it can take up to 2 weeks for the complete effect 

The local anesthetic often provides short-term relief right away. But the steroid effect develops slowly.

How Long Does Pain Relief Last?

Duration of relief depends on the underlying condition -

• Mild inflammation - Weeks to months 

• Disc herniation - Often 3 to 6 months or longer 

• Spinal stenosis - Variable; some patients might need repeat injections.  

Many patients use epidural steroid injections with physical therapy and other rehabilitation treatments to support recovery. 

Are Epidural Steroid Injections Safe?

When trained pain physicians use imaging guidance, ESIs are generally considered a safe treatment option. But, like any procedure, there are risks, including -

• Temporary increase in pain 

• Headache (rare dural puncture) 

• Infection (very rare) 

• Bleeding (especially in patients on blood thinners) 

• Nerve injury (not very common) 

The risk of serious complications is low when doctors carefully evaluate patients and follow proper techniques. 

Who Is a Good Candidate for an Epidural Injection?

You could be a good candidate for an epidural steroid injection if you have -

• Radiating arm or leg pain 

• MRI evidence of nerve compression 

• Pain lasting longer than 4 to 6 weeks 

• Inadequate response to conservative treatment 

ESIs are less effective for -

• Isolated low back pain without nerve involvement 

• Severe mechanical instability 

• Advanced neurological deficits that need surgery 

What Should You Expect After the Injection?

After the procedure, patients can experience -

• Mild soreness at the injection site 

• Temporary numbness or heaviness in the limbs 

• Slow improvement in pain over several days 

Doctors advise patients to -

• Avoid intense activity for 24 hours 

• Resume normal activities as per your comfort level

• Start or continue physical therapy 

Call 631-543-1440 to Book a Same-Day Appointment

Your Common Questions on Epidural Steroid Injections

1. How many epidural steroid injections can I receive in a year?

The number of injections depends on your condition and response to treatment. Your pain specialist will determine an appropriate schedule and limit exposure to steroid medications whenever possible.

2. Can I drive myself home after an epidural steroid injection?

Many patients can drive themselves home after the procedure. But if sedation is used or your doctor recommends it, you should arrange for someone to drive you.

3. Will I need physical therapy after an epidural steroid injection?

Yes. You should opt for physical therapy after an epidural steroid injection. As pain and inflammation decrease, therapy can help improve your strength, flexibility, and overall function to support long-term recovery.

Takeaway

Epidural steroid injections can help reduce your nerve pain caused by conditions affecting the spine. They are not a permanent cure. But they can ease your inflammation, improve movement, and help you get back to your normal activities. 

If you are experiencing radiating neck or back pain that has not improved with conservative care, an epidural steroid injection can be an appropriate next step in your treatment plan. At Groth Pain & Spine, we use image guidance to provide safe, precise treatment as per your needs. 

Turn to Groth Pain & Spine for Advanced Pain Relief

 

At Groth Pain & Spine, we help patients find relief by providing targeted, minimally invasive treatments that address the source of their symptoms. We offer convenient in-office procedures, same-day availability, and work with insurance providers, including Workers' Compensation and No-Fault cases. 

Under the leadership of Dr. Timothy Groth, a board-certified pain management physician with more than two decades of experience, patients receive individualized care backed by advanced diagnostic and treatment techniques. 

Call 631-543-1440 to schedule your appointment and know about your treatment options.