How Epidural Steroid Injections Work
The spine contains an epidural space that surrounds the spinal cord and nerve roots. When inflammation or pressure occurs—often from a herniated disc, spinal stenosis, or degenerative disc disease—nerves can become compressed and painful.
An ESI delivers:
- Corticosteroids to reduce inflammation and swelling
- Local anesthetics to quickly ease pain signals traveling to the brain
By calming inflamed nerves and creating more space around them, epidural injections help relieve pain and support healing.
Conditions Commonly Treated
Doctors may recommend an epidural steroid injection when conservative care hasn’t provided enough relief for conditions such as:
- Lumbar spinal stenosis (learn more)
- Herniated or bulging discs
- Degenerative disc disease
- Sciatica or nerve root pain (radiculopathy)
- Chronic neck or lower back pain
Types of Epidural Steroid Injections
Epidural injections can be performed at different levels of the spine depending on where pain originates.
Cervical Epidural Steroid Injection
Targets the neck region to treat cervical radiculopathy (nerve pain radiating to the arms).
Learn more about the detailed procedure in our cervical-specific guide (this page includes cervical details below).
Lumbar Epidural Steroid Injection
Focuses on the lower back, where nerve compression often causes leg pain or sciatica.
Explore our lumbar epidural steroid injection page for a deeper look.
Caudal Epidural Steroid Injection
Uses an approach through the sacral (tailbone) area to reach the lower spinal canal.
Read more on our caudal epidural steroid injection page.
What to Expect During the Procedure
- Preparation – You may receive a light sedative to help you relax. The injection site is cleaned and numbed with a local anesthetic.
- Needle placement – Guided by fluoroscopy (real-time X-ray), your specialist places a thin needle precisely into the epidural space. A small amount of contrast dye confirms correct placement.
- Injection – The doctor delivers a mixture of long-acting steroid and anesthetic (often lidocaine or bupivacaine).
- Observation – The entire procedure typically takes less than 15 minutes. You’ll rest briefly before going home.
Many patients feel immediate relief from the anesthetic, with steroid benefits continuing to improve over several days.
Recovery and Post-Procedure Care
- You can usually resume normal activities within 24 hours.
- Mild soreness at the injection site is common and can be treated with ice packs and over-the-counter NSAIDs.
- Follow your provider’s instructions for activity, stretching, or physical therapy.
Key Benefits of Epidural Steroid Injection
- Rapid pain relief that can last for weeks or months
- Improved mobility and function, making daily tasks easier
- Reduced dependence on oral pain medications, including opioids
- Minimally invasive with no hospital stay required
- Can help diagnose the source of pain by confirming which nerves are inflamed
Possible Risks and Side Effects
Epidural injections are generally very safe, but like all medical procedures they carry some risk, including:
- Temporary headache or dizziness
- Minor bleeding or bruising
- Infection at the injection site (rare)
- Nerve irritation or allergic reaction to the medication (very rare)
- Short-term increase in blood sugar levels
Your pain specialist will review your health history to ensure the procedure is appropriate.
Supporting Long-Term Spine Health
While epidural steroid injections can provide lasting relief, they are often most effective when combined with:
- Physical therapy and core-strengthening exercises
- Good posture and ergonomic adjustments
- Weight management and healthy activity to protect the spine
Resources
https://www.treatingpain.com/treatments/epidural-steroid-injection/
https://arizonapain.com/treatments/cervical-steroid-injection/
