A spinal corticosteroid injection is a needle injection in the back used to relieve pain or inflammation. Corticosteroids are injected into the epidural space around the spinal nerve roots of the cervical, thoracic, or lumbar portion of the spine, depending on the area that being treated.
Reasons for Procedure
The procedure is done to:
- Reduce pain caused by swelling and irritation around the spine and nerve roots
- Improve physical function for people with persistent low back pain with sciatica
Spinal injections are typically done when pain is not relieved by:
- Ice and heat therapies
- Physical therapy
- Back exercises
- Changes to the physical setup of the work environment
- Changes to physical activities, including work
- Spinal manipulation
Problems from the procedure are rare, but all procedures have some risk. Your doctor will review potential problems, like:
- Allergic reaction to the medication
- Nerve damage
Some factors that may increase the risk of complications include:
- Current infection
- Certain pre-existing medical conditions
- Treatment with blood thinners or certain other medications
- Poor health
What to Expect
Prior to Procedure
You may have the following done before the procedure:
- A brief physical exam
- Imaging studies to look for the location of possible causes of the pain, including:
Talk to your doctor about your medications. You may be asked to stop taking some medications up to one week before the procedure.
A local anesthetic and/or a sedative may be used. They may help to reduce pain and anxiety . You will be awake for the procedure.
Description of the Procedure
You will lie on your side on an x-ray table. The skin on your back will be washed with a sterile solution. A syringe containing corticosteroid medication and a local anesthetic will be injected through the skin and into a space near the spine. X-ray imaging will be used to guide the placement of the needle. Contrast material may also be injected to confirm that the needle is in the right place. The medication will be injected and the needle will be removed from your back. A small bandage may then be placed over the injection site.
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How Long Will It Take?
The procedure will take less than 1 hour. The entire visit takes about 2-3 hours.
Will It Hurt?
The injection of the local anesthetic may burn or sting for a few seconds. After that, you should not feel pain during the procedure.
- You will spend time in a recovery area where your recovery will be monitored.
- Because you were sedated during the procedure, you will need someone to drive you home.
Potential temporary side effects include:
- Brief period of increased pain
- Trouble sleeping
- Facial flushing
- Lightheadedness from low blood pressure
When you return home after the procedure, do the following to help ensure a smooth recovery:
- Rest on the day of the procedure.
- Apply ice packs for soreness at the injection site.
It will take a few days to a week for the medication to reduce the inflammation and pain. You should be able to resume your regular activities the day after the procedure. You should be able to start exercising within 1 week.
Call Your Doctor If Any of the Following Occur
It is important to monitor your recovery. Alert your doctor to any problems. If any of the following occur, call your doctor:
- Severe pain
- Headache that worsens when you sit or stand and improves when you lie down
- Signs of infection, including fever and chills
- Redness, swelling, increasing pain, bleeding, or discharge from the injection site
- Shortness of breath, or chest pain
- Numbness, tingling, pain, or weakness, especially in the arms, hands, legs, or feet
- Changes in urine or bowel function
- Sudden increase in weight of more than 5 pounds
If you think you have an emergency, call for emergency medical services right away.
Know Your Back—North American Spine Society https://www.knowyourback.org
Ortho Info—American Academy of Orthopaedic Surgeons https://www.orthoinfo.org
Canadian Orthopaedic Association http://coa-aco.org
When it Hurts to Move—Canadian Orthopaedic Foundation http://whenithurtstomove.org
Boswell MV, Trescot AM, Sukdeb D, et al. Interventional techniques: evidence-based practice guidelines in the management of chronic spinal pain. Pain Physician. 2007;10(1):7-111.
Epidural steroid injection. EBSCO DynaMed Plus website. Available at: https://www.dynamed.com/topics/dmp~AN~T901362/Epidural-steroid-injection . Updated September 5, 2016. Accessed December 18, 2017.
Epidural steroid injections. Know Your Back—North American Spine Society website. Available at: https://www.spine.org/KnowYourBack/Treatments/InjectionTreatmentsforSpinalPain/EpiduralSteroidInjections.aspx. Accessed December 18, 2017.
Epidural steroid injections: Pros and cons. North Shore Pain Management website. Available at: https://nspaincare.com/blog-170925-epidural-steroid-injections.html. Accessed December 18, 2017.
Spine injection. Massachusetts General Hospital website. Available at: http://www.massgeneral.org/imaging/services/procedure.aspx?id=2268. Accessed December 18, 2017.
- Reviewer: EBSCO Medical Review Board Michael Woods, MD, FAAP
- Review Date: 11/2018
- Update Date: 11/01/2016