In the simplest of terms, an epidural corticosteroid (steroid) injection is a way to deliver pain medicine quickly into the body with a syringe.
The medicine is injected into the epidural area. This is a fat-filled area that covers the spinal cord to protect it and the surrounding nerves from damage.
Sometimes pain relief is short term. Other times the benefits continue for some time.
If you have intense, difficult-to-treat pain in your legs or arms from inflamed spinal nerves, then an epidural steroid injection might give you quick relief. Often, nerve passages from the spine to your arms or legs become narrowed, causing this pain. This narrowing can cause inflammation of the spinal nerves.
A number of conditions may add to this narrowing, including:
Thickening ligaments in the spine because of spinal arthritis
Injected steroids reduce inflammation and opens up these passages to provides pain relief.
An epidural steroid injection generally causes no problems. If you do have side effects, they may include:
"Steroid flush," or flushing of the face and chest, with warmth and an increase in temperature for several days
In rare instances, pain that actually increases for several days after the procedure
Serious complications are rare but can include:
Tips for preparation include the following:
An epidural steroid injection is generally an outpatient procedure. You may be asked to change into a surgical gown to make the injection process easier.
You may want to ask for a mild sedative, but most people receive just local anesthetic.
If you have diabetes, an allergy to contrast dye, or certain other medical conditions, you'll want to discuss any concerns with your healthcare provider before getting the procedure.
Based on your medical condition, your healthcare provider may request other specific steps.
An epidural steroid injection is a simple procedure:
Your healthcare provider will use an X-ray machine showing moving images on a screen to guide the needle as the provider makes the injection and ensures that the needle is in the correct location.
Contrast dye is injected at the site to make sure that the medicine will be sent to the exact place it needs to go.
The healthcare provider will inject the steroid medicine itself, often along with a local anesthetic to help with pain relief.
Once the procedure is done, you can return home. Usually, you'll be able to return to normal activities on the next day. The steroids usually start working within 1 to 3 days. In some cases, you might need up to a week to feel the benefits.
Many people get several months of improvement of pain and function from the injections. If the injection is effective, it can be repeated. If you have any side effects, be sure to contact your healthcare provider.
If you don't have pain relief, talk with your healthcare provider. This may be a sign that the pain is coming from some place other than the spinal nerves.
Before you agree to the test or the procedure make sure you know:
The name of the test or procedure
The reason you are having the test or procedure
What results to expect and what they mean
The risks and benefits of the test or procedure
What the possible side effects or complications are
When and where you are to have the test or procedure
Who will do the test or procedure and what that person’s qualifications are
What would happen if you did not have the test or procedure
Any alternative tests or procedures to think about
When and how you will get the results
Who to call after the test or procedure if you have questions or problems
How much you will have to pay for the test or procedure