Epidural Steroid Injections

What is an Epidural Steroid Injection?

Chronic back or nerve pain often stems from inflammation around the spinal nerves. One option to address this is an epidural steroid injection, a minimally invasive procedure designed to calm irritated nerves and ease discomfort. The treatment involves carefully delivering a corticosteroid medication, often combined with a local anaesthetic, into the epidural space, which is the area surrounding the spinal cord and nerve roots.

By targeting the source of inflammation directly, this procedure can provide relief that oral medications or physiotherapy may not achieve. It is not a permanent cure, but it can be a valuable step in a broader treatment plan, allowing patients to move more comfortably and participate in rehabilitation.

What are the types of Epidural Steroid Injections?

These injections are classified in 2 ways which are either by the location in the spine where they are given or by the technique used to deliver the medication.

By location:

Cervical – administered in the neck area to treat pain radiating to the shoulders and arms.
Thoracic – performed in the mid-back to relieve symptoms affecting the chest or upper abdomen.
Lumbar – placed in the lower back, commonly used for slipped discs or sciatica.

By technique:

Interlaminar – the needle is positioned between two vertebrae to deliver medication over a wider area.
Transforaminal – the steroid is injected through the small openings where individual nerves exit the spine, allowing highly targeted treatment.
Caudal – medication is introduced via the sacral hiatus at the base of the spine, often used when multiple nerve roots are involved.

How does an Epidural Steroid Injection work?

Epidural steroid injections help relieve nerve pain by delivering anti-inflammatory medication directly into the area surrounding the spinal nerves. This approach targets inflammation at its source, reduces pressure on the nerves, and eases pain signals sent to the brain.

The injections work by:

Preparation and positioning — the patient is positioned to give the doctor clear access to the spine. The skin is cleaned, and a local anaesthetic may be applied to minimise discomfort.
Medication delivery — using a fine needle, steroids and sometimes a local anaesthetic are carefully injected into the epidural space, the area between the protective spinal membranes and the surrounding tissues.
Targeted anti-inflammatory action — once in place, the steroid works to suppress inflammatory chemicals that irritate the nerves. This reduces swelling and pressure around the affected nerve roots.
Pain relief and recovery — as inflammation settles, patients typically notice reduced pain and improved mobility. While some relief can occur within days, the full effect usually develops gradually over several weeks.

What are the benefits of an Epidural Steroid Injection?

This procedure is valued for its ability to provide pain relief without major surgery. The benefits include:

Alternative to stronger medication – may reduce the need for long-term reliance on oral painkillers or opioids.
Improved mobility – by lessening discomfort, many patients can return to daily activities or physiotherapy more effectively.
Minimally invasive approach – carried out as an outpatient procedure with minimal downtime.
Reduction of pain and inflammation – easing symptoms such as tingling, numbness, or shooting pain down the arms or legs.
Targeted treatment – medication is delivered directly to the source of nerve irritation.

What injuries or conditions can an Epidural Steroid Injection treat?

Doctors may recommend this treatment for a range of painful spinal conditions, including:

Bone spurs – overgrowth of bone that presses on the spinal cord or nerves.

Failed back surgery syndrome – persistent pain even after spinal surgery.

Herniated (slipped) discs – when part of a disc bulges or ruptures, compressing nearby nerves.

Nerve root cysts (Tarlov cysts) – fluid-filled sacs that put pressure on adjacent nerves.

Scoliosis – abnormal spinal curvature irritates surrounding nerves.

Spinal injuries – trauma leading to vertebral fractures or nerve root irritation.
Spinal stenosis – narrowing of the spinal canal that squeezes the spinal cord or nerve roots.

What are the side effects of an Epidural Steroid Injection?

Most people tolerate the procedure well, but as with any medical treatment, side effects can occur. The majority are mild and temporary, though rare complications may be serious.

Some of the possible side effects may include:

Allergic reaction to the medication, such as flushing or rash
Headache caused by fluid leakage around the injection site
Local soreness, numbness, or tingling for a short period
Small risk of infection or bleeding at the site of injection
Temporary weakness in the treated area

Meanwhile, some of the rare complications are:

Intraspinal bleeding leading to nerve damage
Needle-related nerve injury
Severe infections such as meningitis or abscess formation
Spinal or cerebral infarction (stroke of the spinal cord or brain)

What can I expect during an Epidural Steroid Injection procedure?

The procedure is usually completed within 30 to 60 minutes and does not require an overnight stay. It generally entails:

Consultation – our doctor will go over your symptoms, medical history, and check if the injection is right for you.
Preparation – you may need to change into a gown, and the area where the injection will be given is cleaned and numbed with a local anaesthetic.
Injection – guided by imaging like an X-ray, our doctor carefully places the needle in the epidural space and delivers the steroid. Sometimes a local anaesthetic is included for immediate relief.
Aftercare – a small dressing is put on the site, and you’ll be observed briefly before heading home.

What should I expect after an Epidural Steroid Injection?

It is common to feel mild soreness or heaviness at the injection site for a day or two. Some patients notice that their pain briefly increases before improving as the medication takes effect.

Most individuals can resume light activities the same day, but strenuous exercise or heavy lifting should be avoided for a short period. Our doctor may also recommend physiotherapy or stretching exercises to maintain mobility and strengthen supporting muscles.

How long does it take for an Epidural Steroid Injection to take effect?

Relief is not always immediate. Some patients notice improvement within a few days, while others may need up to a week before the benefits become clear. If pain persists or worsens after 7 to 10 days, you should inform your doctor immediately.

How long do the effects of an Epidural Steroid Injection last?

The duration of pain relief varies. For some, it lasts only a few weeks, while others experience benefits for several months. In suitable cases, repeat injections, usually no more than 3 to 4 per year, can help maintain comfort over time.

Summary

Epidural steroid injections offer a non-surgical way to manage back and nerve pain caused by conditions such as slipped discs, spinal stenosis, or nerve irritation. By delivering powerful anti-inflammatory medication directly to the affected area, this treatment can reduce pain, improve mobility, and support rehabilitation.

Although not a cure, it may be a valuable part of your treatment plan, especially if other approaches have not provided relief. If you are struggling with persistent spinal or nerve pain, speak with our team to find out if an epidural steroid injection could help restore your quality of life.