About Epidural Steroid Injections
The epidural space surrounds the spinal nerves as they leave the spine. When a disc herniation or narrowing of the spinal canal presses on a nerve, the nerve becomes inflamed and pain can travel down an arm or leg. An epidural steroid injection delivers a corticosteroid, a strong anti-inflammatory medication, directly to that area.
Epidural injections work best for radiating nerve pain rather than pain limited to the middle of the back. Many disc herniations shrink and settle on their own over time, and an injection can make that period more tolerable while you keep moving.
Dr. Chen uses X-ray guidance with a small amount of contrast dye to confirm the medication flows where it is needed. The approach, whether between the vertebrae or alongside the nerve root, is chosen based on your imaging and symptoms.
What happens during treatment
- 1.
Dr. Chen reviews your symptoms, exam, and MRI to confirm that nerve irritation is the likely source of your pain.
- 2.
You lie face down on the procedure table, and the skin is cleaned and numbed.
- 3.
Under X-ray guidance, a thin needle is guided to the epidural space and contrast dye confirms the position.
- 4.
The steroid and a local anesthetic are injected. You rest briefly and go home the same day with a driver.
Who may be a good candidate
- People with sciatica or arm pain from a herniated disc that has not improved enough with time and rehab.
- People with spinal stenosis who develop leg pain with standing or walking.
- People who want to delay or avoid spine surgery when there is no progressive weakness.
Recovery
Take it easy for the rest of the day, then return to normal activity. Your pain may briefly increase for a day or two before the steroid takes effect, which often happens within several days to two weeks. We encourage you to keep walking and to continue your rehab program as pain allows.
Risks and limits
Temporary side effects can include soreness, facial flushing, trouble sleeping, mood changes, and higher blood sugar in people with diabetes. A headache can occur if the needle punctures the covering of the spinal fluid. Infection, bleeding, and nerve injury are rare, and serious neurologic complications are very rare. Steroid injections are limited in how often they can be given. Seek urgent care for new leg weakness, numbness in the groin, loss of bladder or bowel control, or fever with back pain; these may need emergency evaluation or surgery.
What to expect at your visit
- 1.
We listen first
Your visit opens with a real conversation: how the problem started, what you have already tried, and the activity you want back.
- 2.
Exam and in-office ultrasound
A hands-on exam, then ultrasound at the exam table, often while you move, so your physician can see the tendon, joint, or nerve involved.
- 3.
A clear diagnosis and plan
You leave knowing what is wrong and what your options are, from strength-based rehab to procedures, and why we recommend each one.
- 4.
Treatment and follow-through
Most procedures happen here in the office. We coordinate with your physical therapist and check progress against the goals you set.
Questions about Epidural Injections
- How long does an epidural steroid injection last?
- Relief varies from weeks to several months, and some people do not need another injection because the nerve settles on its own. If relief is short-lived, we reassess the cause and the plan.
- How many epidural injections can I have?
- Because of the effects of steroids on the body, injections are spaced out and limited in number each year. Dr. Chen will recommend a safe schedule based on your health and response.
- Will I need surgery if the injection does not help?
- Not necessarily. Many people improve with time, rehab, and other treatments. Surgery is worth discussing if you have progressive weakness, signs of spinal cord compression, or severe pain that persists, and we can coordinate that referral.