Spinal Corticosteroid Injection
(Spinal Steroid Injection; Epidural Steroid Injection)
A spinal corticosteroid injection places corticosteroids into tissue around the spine. Corticosteroids are drugs that reduce painful swelling and irritation. They are injected into the back with a needle.
Reasons for Procedure
The procedure is done to:
- Reduce pain caused by swelling and irritation around the spine
- Improve physical function for people with persistent low back pain and/or sciatica
Spinal injections are typically done when pain is not relieved by:
- Ice and heat therapies
- Physical therapy
- Back exercises
- Changes to the physical set-up of the work environment
- Changes to physical activities, including work
- Spinal manipulation
Problems from the procedure are rare, but all procedures have some risk. Your doctor will review potential problems, like:
- Allergic reaction to the medication
- Nerve damage
Some factors that may increase the risk of complications include:
- Current infection
- Certain pre-existing medical conditions
- Treatment with blood thinners or certain other medications
- Poor health
What to Expect
Prior to Procedure
You may have the following done before the procedure:
- A brief physical exam
- Imaging studies to look for the location of possible causes of the pain, including
Talk to your doctor about your medications. You may be asked to stop taking some medications up to one week before the procedure.
A local anesthetic and/or a sedative may be used. They may help to reduce pain and anxiety. You will be awake for the procedure.
Description of the Procedure
You will lie on your side on an x-ray table. The skin on your back will be washed with a sterile solution. A syringe containing corticosteroid medication and a local anesthetic will be injected through the skin and into a space near the spine. X-ray imaging will be used to guide the placement of the needle. Contrast material may also be injected to confirm that the needle is in the right place. The medication will be injected and the needle will be removed from your back. A small bandage may then be placed over the injection site.
How Long Will It Take?
The procedure will take less than one hour. The entire visit takes about 2-3 hours.
Will It Hurt?
The injection of the local anesthetic may burn or sting for a few seconds. After that, you should not feel pain during the procedure.
At the Care Center
- You will spend time in a recovery area where your recovery will be monitored.
- Because you were sedated during the procedure, you will need someone to drive you home.
Potential temporary side effects include:
- Brief period of increased pain
- Trouble sleeping
- Facial flushing
- Lightheadedness from low blood pressure
When you return home after the procedure, do the following to help ensure a smooth recovery:
- Rest on the day of the procedure.
- Apply ice packs for soreness at the injection site.
It will take a few days to a week for the medication to reduce the inflammation and pain. You should be able to resume your regular activities the day after the procedure. You should be able to start exercising within one week.
Call Your Doctor
It is important to monitor your recovery. Alert your doctor to any problems. If any of the following occur, call your doctor:
- Signs of infection, including fever and chills
- Redness, swelling, increasing pain, bleeding, or discharge from the injection site
- Shortness of breath or chest pain
- Numbness, tingling, pain, or weakness, especially in the arms, hands, legs, or feet
- Changes in urine or bowel function
- Sudden increase in weight of more than five pounds
If you think you have an emergency, call for medical help right away.
American Association of Neurological Surgeons
Ortho Info—American Academy of Orthopaedic Surgeons
Canadian Orthopaedic Association
Canadian Orthopaedic Foundation
Epidural steroid injections. Know Your Back website. Available at: http://www.knowyourback.org/Pages/Treatments/InjectionTreatments/ES_Injections.aspx. Published July 17, 2009. Accessed November 25, 2013.
Lumbar epidural steroid injections. Beverly Pain Management website. Available at: http://www.pain-clinic.org/lumbarepiduralsteroidinjections. Accessed November 25, 2013.
Manchikanti L, Staats PS, Singh V, et al. Evidence-based practice guidelines for interventional techniques in the management of chronic spinal pain. Pain Phys. 2003;6:3-81.
Last reviewed December 2014 by Michael Woods, MD
Please be aware that this information is provided to supplement the care provided by your physician. It is neither intended nor implied to be a substitute for professional medical advice. CALL YOUR HEALTHCARE PROVIDER IMMEDIATELY IF YOU THINK YOU MAY HAVE A MEDICAL EMERGENCY. Always seek the advice of your physician or other qualified health provider prior to starting any new treatment or with any questions you may have regarding a medical condition.