Spinal Corticosteroid Injection
(Spinal Steroid Injection; Epidural Steroid Injection)
DefinitionA spinal corticosteroid injection places corticosteroids into tissue around the spine. Corticosteroids are drugs that reduce painful swelling and irritation. They are injected into the back with a needle.
Reasons for ProcedureThe procedure is done to:
- Reduce pain caused by swelling and irritation around the spine
- Improve physical function for people with persistent low back pain and/or sciatica
- Ice and heat therapies
- Physical therapy
- Back exercises
- Changes to the physical set-up of the work environment
- Changes to physical activities, including work
- Spinal manipulation
Possible ComplicationsProblems 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
- Current infection
- Certain pre-existing medical conditions
- Treatment with blood thinners or certain other medications
- Poor health
What to Expect
Prior to ProcedureYou 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
AnesthesiaA 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 ProcedureYou 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 one 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.
Post-procedure CareAt the Care Center
- 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
- Rest on the day of the procedure.
- Apply ice packs for soreness at the injection site.
Call Your DoctorIt is important to monitor your recovery. Alert your doctor to any problems. If any of the following occur, call your doctor:
- 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 five pounds
American Association of Neurological Surgeons
Ortho Info—American Academy of Orthopaedic Surgeons
Canadian Orthopaedic Association
Canadian Orthopaedic Foundation
Epidural steroid injections. Know Your Back website. Available at: http://www.knowyourback.org/Pages/Treatments/InjectionTreatments/ES%5FInjections.aspx. Published July 17, 2009. Accessed November 25, 2013.
Lumbar epidural steroid injections. Beverly Pain Management website. Available at: http://www.pain-clinic.org/lumbarepiduralsteroidinjections. Accessed November 25, 2013.
Manchikanti L, Staats PS, Singh V, et al. Evidence-based practice guidelines for interventional techniques in the management of chronic spinal pain. Pain Phys. 2003;6:3-81.
- Reviewer: Michael Woods, MD
- Review Date: 12/2014
- Update Date: 12/20/2014