What is an epidural steroid injection?
An epidural steroid injection places anti-inflammatory medication - a corticosteroid, usually combined with a local anesthetic - into the epidural space, the area just outside the covering of the spinal nerves. When a disc herniation or narrowing irritates a nerve, that nerve becomes inflamed and can send pain, tingling, or weakness down the arm or leg. The steroid works to calm this inflammation, easing the radiating pain closer to its source.
It is not surgery and does not remove a disc or widen a narrowed canal. It may be used to reduce inflammation while you continue a wider treatment plan, or to help clarify whether symptoms are coming from a particular nerve distribution.
What happens during the procedure
The injection is carried out as a day case using image guidance - fluoroscopy, a live X-ray - so the medication reaches exactly the right spot. You lie on your front, the skin is numbed with local anesthetic, and a fine needle is guided into position. A small amount of contrast dye may be used to confirm placement before the medication is given. Light sedation can be offered to help you relax. The injection itself usually takes only a few minutes, and there is no incision.
Benefits and considerations
The response varies: symptoms may improve, change temporarily or remain unchanged. The injection treats inflammation rather than the underlying disc or stenosis and is not a cure. Repeating it depends on the response, steroid exposure, your health and the specialist’s assessment.
What to expect afterwards
You will be observed according to the medication and sedation used. Arrange an escort if required and follow the clinic’s instructions for driving and activity. Temporary soreness or a pain flare can occur. Seek advice urgently for new weakness, loss of bladder or bowel control, fever or a severe headache.
How we approach your care
- 01
Find the true source
We begin with a thorough history and examination, supported by imaging where appropriate, to pinpoint the precise source of the problem.
- 02
Consider appropriate options
Where clinically appropriate, we consider established non-surgical options before surgery. The plan depends on the diagnosis, symptoms, health and priorities of the individual patient.
- 03
A plan built around you
Every step is explained clearly, so you always understand your options and what comes next.
This may help if
- You have radiating leg or arm pain from an irritated spinal nerve
- An MRI shows a herniated disc or narrowing that matches your symptoms
- Physiotherapy and medication have not settled the pain on their own
- You would like to calm a nerve flare so you can take part in rehabilitation
Suitability can only be assessed after reviewing your symptoms, examination, relevant imaging and previous treatment.
Common questions
Does an epidural steroid injection hurt?
Most people feel a brief sting as the local anesthetic numbs the skin, then pressure rather than sharp pain. The injection itself usually takes only a few minutes, and light sedation can be offered to help you relax. There is no incision, just a fine needle guided into place under X-ray.
How soon does it start working, and how long does relief last?
The timing and degree of response vary. Some people notice improvement, some have a temporary change, and others have little or no benefit. Your response is reviewed before any repeat injection or next step is considered.
How many injections can I have?
The number is usually limited over a year, because repeated steroid doses carry their own considerations. An injection is best used as a targeted step, not an open-ended treatment. Your specialist will judge whether and when to repeat one, based on how well the first injection helped and for how long.
Is an epidural injection a cure for my back problem?
No. It targets inflammation around an irritated nerve but does not remove a disc or widen a narrowed canal. It may be used as one part of a wider plan that includes activity guidance, medication or physiotherapy.
Is the procedure safe?
Possible effects include temporary soreness, a pain flare, flushing, a change in blood sugar and steroid-related effects. Other risks include infection, bleeding, headache from a dural puncture, nerve injury and reaction to medication or contrast. Your specialist will explain which risks apply to you.
Can I drive home afterwards?
Do not drive if sedation was used; arrange an escort and follow the instructions given by your clinic. Advice after local anesthetic alone depends on your symptoms, movement and the clinic's discharge policy.