Lumbar epidural steroid injections can help relieve pain in the lower back and legs due to certain health conditions. In some cases, you may need additional injections to relieve pain.
A doctor may recommend a lumbar epidural steroid injection to help manage pain that originates from your lower spine. But it isn’t a cure for chronic lower back pain, and some people may need additional injections over time.
Learn the answers to some frequently asked questions about this treatment.
A lumbar epidural steroid injection can relieve pain in your lower back or legs caused by inflammation of the nerves in your spine that has not improved with less invasive treatment. If a few days of bed rest and pain relievers do not work, a doctor may recommend an injection.
Steroids, also called corticosteroids, are medications that bring down inflammation. Your doctor gives the injection into the epidural space around the spinal cord in your lower back.
You might get a lumbar steroid injection if you have pain from:
- a herniated disc
- spinal stenosis
- degenerative spine disease
- bone spurs
- spondylosis
Everyone responds to the procedure differently. In general, a lumbar epidural steroid injection can be a bit uncomfortable, but it shouldn’t be painful. If needed, you can ask your doctor for a mild sedative to relax you before the procedure.
Your doctor first injects a local anesthetic into the skin on your back to numb the area. The injection may cause a mild burning or stinging sensation.
You typically feel some pressure when your doctor inserts the needle into the epidural space to inject the steroid medication. If you feel pain, the doctor can give you more of the local anesthesia to relieve it.
The epidural injection usually starts relieving back pain within 2–3 days. But sometimes, it can take up to a week to see an improvement.
This treatment isn’t a cure for back pain, although some people do get permanent relief. Typically, if you’ve had chronic back pain, the injection may continue to work for 3–6 months or longer. How long they last may also depend on the underlying condition and how many injections you receive. Some research suggests that may have a benefit up to
If the pain returns, you may need to get injections a few times a year. To potentially help extend the effects of this treatment, you may want to consider:
- exercising regularly
- not smoking
- staying at a moderate weight for your body
Recovery from an epidural steroid injection is usually quick.
You won’t be able to drive for the rest of the day and will need someone to help you get home from the appointment.
Avoid soaking in a tub, pool, shower, or any other water or applying heat until your doctor says you can resume these activities.
You can typically go back to your usual activities the day after the procedure. But soreness might keep you from more strenuous activities, such as exercise, for a few days.
Your back might be a little sore for a few days after the injection. Holding an ice pack to the area three or four times per day and taking an over-the-counter pain reliever, such as acetaminophen (Tylenol), can help.
Epidural steroid injections are safe overall. The most common side effects are mild and may include:
- pain at the injection site
- redness of your face and chest, called a steroid flush
- trouble sleeping
- anxiety
- hot flashes
- an increase in blood sugar levels
- fluid buildup
- increased back pain
- headache
These side effects should improve without treatment within 1–3 days.
More serious problems are
- bleeding
- allergic reaction
- infection
- nerve damage
- numbness or tingling
- paralysis
- vertebral fracture
The chance of serious problems can increase with the number of injections you receive.
Let your doctor know if your back still hurts a few days after the injection.
Call your doctor’s office or emergency services right away if you have more serious side effects, such as an allergic reaction or changes in sensation. Call 911 or go to an emergency room if you need emergency care.
Before receiving an epidural steroid injection, it’s best to discuss the benefits and risks of this treatment with your doctor.
Epidural steroid injections temporarily — and sometimes permanently — relieve back and leg pain from conditions such as a herniated disc or degenerative spine disease. Results can last for several months.
If you get a steroid injection and your pain doesn’t improve, talk with your doctor. The pain may not be coming from nerves in your spine, or you may need a different form of treatment, such as surgery. Doctors typically won’t recommend additional injections if the first one didn’t improve your pain.
You may need more tests to figure out the cause and a different type of treatment to relieve it.