Epidural steroid injections provide diagnostic data and pain relief by delivering local anesthetic (numbing medication) and anti-inflammatory steroid medications into the spinal area on the surface of the spinal column. This procedure may reduce inflammation, resulting in long-term pain relief, and can provide valuable information on the source of your pain.

During the procedure—what to expect

• Using a thin needle and X-ray-guidance (fluoroscopy), an anesthesiologist will inject contrast (X-ray dye) into or adjacent to the epidural space thought to be causing your pain. This will ensure correct placement of the needle for the procedure
• X-rays are taken, and a combination of an anti-inflammatory (steroid) and anesthetic (numbing) medications are then injected for pain relief
• You will remain awake during the 10–20 minute procedure, and may experience some slight pressure or discomfort during the injection
• Please inform the anesthesiologist how it differs from your usual symptoms
• You will be asked to wait 30–40 minutes after your procedure before leaving

After the procedure—what to expect

• You may experience numbness and/or relief from your symptoms for up to six hours after the injection
• Your usual symptoms may then return and may possibly be worse than usual for a day or two
• The beneficial effects of the steroids usually require two to three days to take hold, but may take as long as five to seven days. If there is no change in your symptoms after a week, your doctor may want to investigate other possible sources for your pain
• If an initial injection provided a certain amount of relief, a second injection might strengthen the pain relief effect. Also, if your pain subsides, but begins to return weeks or months later, additional injections—up to four a year—are possible

Keep track of how long relief lasts and report it to your physician. If there is no change in the pain, then investigation can be focused on other possible sources of your pain. In either case, the information is useful to the doctor who referred you for this procedure.

Possible side effects

• Steroid medications may cause facial flushing, occasional low-grade fevers, hiccups, insomnia, headaches, water retention, increased appetite, increased heart rate, and abdominal cramping or bloating.
• These side effects occur in only about 5 percent of patients and commonly disappear within one to three days after the injection.