Epidural Corticosteroid Injections

What is an epidural steroid injection?

Your doctor may recommend epidural steroid injections for relief from pain that radiates to the arms and legs due to conditions such as disc herniation, bone spurs, or joint cysts. Steroid injections may be tried after other noninvasive treatment approaches, such as anti-inflammatory medications or physical therapy, have failed to relieve your pain.

Before an epidural steroid injection, you will have an X-ray or MRI (or both) to determine exactly where the spinal nerves are being compressed and where the pain is coming from. For the procedure, your doctor uses X-ray guidance to locate the spot and inject it with a numbing and pain-relieving medication followed by the steroids, which reduce inflammation or swelling that is causing pressure on nerves and producing pain.

What to expect with a steroid injection

The procedure is done on an outpatient basis and only takes about 20 minutes. It is performed with local anesthesia (numbing agent) but you may request medication to make you drowsy and more relaxed. You will need to have someone drive you home afterward. In some patients, there is immediate pain relief, which may last for a few weeks or months as inflammation decreases and the body is better able to repair itself. In other cases, multiple rounds of steroid injections are required, usually about six weeks apart. It is possible for the first injection to provide little relief, but for the second or third one to make a significant difference. Because steroids can have side effects, such as bone weakening and hormonal disruption, the injections are generally not given more than three times a year.

Your doctor will discuss the procedure with you and explain what to expect. He or she can also talk with you about additional treatment options beyond epidural steroid injections, if needed.