If your doctor has mentioned an “epidural” for back or leg pain, you probably have questions. Is it the same as the epidural used in childbirth? Does it hurt? How long does it last? Here’s a straightforward walkthrough.
What it is
An epidural steroid injection (ESI) places a corticosteroid, often with a local anesthetic, into the epidural space, the area around the spinal nerves. The steroid is meant to reduce inflammation of an irritated nerve root. It’s related to, but not the same as, the labor epidural, which is a continuous anesthetic for childbirth.
Common approaches include transforaminal (near where a specific nerve exits), interlaminar, and caudal (from the base of the spine). Your physician chooses based on your anatomy and symptoms.
Who it may help
- Arm or leg pain from a herniated disc
- Sciatica that isn’t improving with therapy
- Leg pain with walking from lumbar spinal stenosis
Injections tend to work best for radiating nerve pain rather than general, axial low back ache.
Before the procedure
- Tell your physician about all medications, especially blood thinners and diabetes medications. Some may need adjustment, but only stop a medication if your prescribing doctor tells you to.
- Mention allergies (including to contrast dye), pregnancy, or any current infection or fever.
- Arrange a ride home if you’ll receive sedation, or if your physician recommends it.
During the procedure
You typically lie face down. The skin is cleaned and numbed. Using live X-ray (fluoroscopy) and often contrast dye to confirm placement, the physician guides a thin needle to the target and injects the medication. Most patients describe pressure and brief discomfort. The injection itself usually takes only minutes, and you’ll be monitored for a short time afterward.
After the procedure
- Some people feel numbness or relief right away from the anesthetic, which wears off within hours.
- The steroid’s effect often takes a few days to begin.
- Temporary soreness at the site, facial flushing, trouble sleeping or a short-term rise in blood sugar can occur.
- Many physicians recommend taking it easy the day of the procedure and resuming normal activity after that.
How long does relief last?
It varies. Some patients get lasting relief, some get weeks to months, and some get little benefit. The most important thing is to use the window of relief to do the active work, physical therapy and home exercise, that addresses why the pain started.
Questions to ask your pain physician
- What do you expect this injection to help with, and how will we know if it worked?
- Which approach will you use, and why?
- What are the risks for me specifically?
- What’s the plan if it doesn’t help?
Questions New Jersey patients ask
Do epidural steroid injections hurt?
The skin is numbed first. Most patients feel pressure and brief discomfort rather than sharp pain.
How many injections can I have?
Physicians limit how often steroids are given. Your doctor will decide based on your response and overall health.
Are there alternatives?
Yes, including physical therapy, chiropractic care, medication changes, other targeted procedures and, in some cases, surgery. A good plan weighs all of them.
Our pain management physicians evaluate whether an injection fits your situation. Call (855) 425-1900 or request an appointment online.
This article is general education, not medical, legal or insurance advice. Every injury and every policy is different. If you have severe or worsening symptoms, call 911 or go to the nearest emergency department.
