Guide to Epidural Steroid Injections

Dr. Constantine Toumbis

12 February 2021

An epidural steroid injection is a simple procedure to deliver pain medicine more quickly by injecting it directly into the dura mater — the connective tissue of the brain and spinal cord. This treatment can provide relief from neck pain or back pain, usually lasting a few months to a year, and improve your quality of life without major surgery.

If you’re suffering from chronic neck or back pain but want to explore less invasive treatment options, epidural steroid injections may be a good treatment for you. 

When to Consider an Epidural Steroid Injection

Any patient with neck or back pain due to inflamed spinal nerves may want to consider epidural steroid injections, especially if the pain is unresponsive to other treatments or is affecting their day-to-day life. 

If you find yourself having difficulty standing, sitting, working, sleeping, or just moving about your day, talk to your doctor about whether epidural steroid injections can provide some targeted relief. 

The procedure can provide particular relief for a number of conditions, including:


Epidural steroid injections are an especially beneficial treatment method because they are minimally invasive, meaning patients recover more quickly and with fewer side effects. Most orthopedic surgeons recommend exploring these types of conservative measures before exploring surgical options. 

How Epidural Steroid Injections Work

An epidural steroid injection is a simple procedure. The entire process typically takes less than an hour.

Here’s a step-by-step look at what to expect during your appointment:

  1. Your doctor will start by using an ultrasound or X-ray machine to locate the affected area. At Citrus Spine we use high-resolution live X-ray machines, which allow us to use the thinnest and least painful injection needles.
  2. You will receive a local anesthetic to numb the area as well as a shot of corticosteroid, a drug that lowers inflammation in the body. The injection should be uncomfortable, but not painful, and the numbing agent takes effect quickly.
  3. Most patients feel relief from the numbing agent immediately and more lasting relief within a few hours to a few days.

What are the Risks of Epidural Steroid Injections?

An epidural steroid injection is an extremely low-risk procedure, but side effects can occur in some patients. The most common is called “steroid flush,” a flushing of the face and chest and feeling of warmth following the injection that can last for up to a few days. 

Other, less-common side effects include trouble sleeping, anxiety, menstrual changes or water retention. A more serious but rare side effect is infection at the injection site, which occurs in less than 1% of patients.

Be sure to talk to your doctor about your specific risks for complications and what to expect after the procedure. And contact your doctor immediately if you experience severe side effects following the injection.

How to Prepare for an Epidural Steroid Injection

Prior to any medical procedure, you should provide your doctor with a full list of your regular medications, especially blood thinner medications or dietary supplements. You may need to stop taking these for several days prior to the epidural steroid injection to reduce the risk of bleeding or bruising at the injection site.

You should also discuss any other conditions or concerns you have with your doctor prior to the procedure. They may be able to provide specialized instructions based on your current conditions and medical history.

What to Expect After an Epidural Steroid Injection

Epidural steroid injections are simple outpatient procedures, and you are usually in and out of the office in less than an hour. Following an epidural steroid injection, you may experience some soreness at the injection site for a day or two. If this occurs, an ice pack can provide comfort to the area.

The numbing agent will wear off within a few hours of the procedure, and you can expect more lasting pain relief within a few days. For most patients this relief lasts for several months to a year. If the injection is effective, it can be repeated for additional results.

The success rate for epidural steroid injections will vary based on the patient’s condition, but studies have shown significant pain relief in up to 80% of patients with a lumbar herniated disc and up to 87% of patients with mild to moderate spinal stenosis.

If you don’t experience pain relief or have negative side effects, call your doctor. They may want to discuss alternative treatment options for you or explore your condition further.

Is Epidural Steroid Injection Right For You?

At Citrus Spine, spinal health and pain relief are at the core of everything we do. Our specialized spine practitioners would love to talk more with you about your experience and whether epidural steroid injection might be right for you. 

Let us take a look at your symptoms, history, and lifestyle needs to choose a treatment plan curated for you. Contact us to start the conversation.

If you are experiencing back pain symptoms, you should never ignore or try to suffer through the pain. Always consult your doctor and have open conversations. If you are not satisfied with your doctor or require specialized care, it is recommended to get a second opinion from a back pain specialist.

Dr. Constantine Toumbis

Dr. Toumbis is a board certified, fellowship trained orthopedic surgeon specializing in cervical, thoracic and lumbar surgery. He received his undergraduate degree in Biology from New York University in 1987, then continued on to receive his Masters in Natural Sciences as well as a PhD in Experimental Pathology from State University of New York at Buffalo. He completed his medical degree at Wayne State University School of Medicine with a distinction in Biomedical Research. After moving to Florida to complete his internship and residency in orthopedics at the University of Florida Shands Hospital, he went on to pursue a fellowship at Cleveland Clinic's Florida Spine Institute. He moved to Citrus County and has been in private practice since 2005.

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