Epidural Steroid Injections

An epidural steroid injection is an injection of prednisone-like medication into the epidural space near the spine to treat back pain caused by herniated discs or spinal stenosis. The procedure is similar to one used to treat a mother’s labor pain before the birth of a baby. However in an epidural steroid injection a different kind of medication is used. The procedure usually takes about 5 to 15 minutes to perform and your visit will take approximately 30 to 45 minutes. During the injection you will be lying on your stomach.

A fluoroscopic x-ray unit will be used to guide the needle. Your back will be washed with an anti-septic solution to clean the skin. A local anesthetic will be injected into in the skin in order to minimize any pain that you might feel. A small needle will then be used to give the injection. Most often the injections are given in the low back near the level of your hips. The technique requires a sensitive touch therefore it will be necessary for you to remain still for a number of minutes during the injection. Following the injection, you will rest for approximately 5 to 10 minutes before leaving. 


Steroids are anti-inflammatory drugs. Many doctors believe that back pain caused by herniated discs or spinal stenosis involves a significant inflammatory component caused by chemical or mechanical irritation or an autoimmune response. Although oral steroids can be used to treat this, epidural steroids have the advantage of being delivered to the site of inflammation and therefore are more effective even though a smaller dose can be used. Using a small dose minimizes the side effects. 


Epidural steroids may take up to a week to become effective. Many patients will not notice a difference in their pain for at least two or three days. In addition, the pain may start to return after a few days to a week following the first injection. For this reason we may do two or three injections, spaced ten to fourteen days apart. Most patients (approximately 60% to70%) will experience a significant reduction in their pain following the series of injections. If your pain returns, we can perform another injection.

Epidural steroid injections are only part of a comprehensive approach to the treatment of back pain. Epidural steroid injections do not “cure” the problem, but decrease the pain and inflammation and allow you to continue your daily activities while your body repairs itself. Therefore you should continue taking your pain medication as necessary, start a graded, mild exercise program, which includes flexibility exercises, reevaluate and if necessary change poor body mechanics and continue in physical therapy if it has been prescribed.