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Epidural Steroid Injections for Back Pain

The Spinal cord is in the bony structure of the vertebral column and is covered by the dural sac. This sac contains spinal fluid that bathes and nourishes the spinal cord. The epidural space is between the outer surface of the dural sac and the bones of the vertebral column.

Nerves from the legs, including the sciatic nerve, enter the vertebral column and go through the dural sac to reach the spinal cord. These nerves can become irritated and cause pain in the legs. Pain can shoot down the legs. This is called sciatica.

With an epidural steroid injection, steroid medicine is put into the epidural space to ease the irritation of the spinal nerves to relieve pain. Also, the steroid acts like a local anesthetic and blocks the pain so the body can repair itself.


Be sure to talk to your doctor before this injection if you:


  • Have any allergies

  • Take a blood thinning medicine such as Coumadin, Plavix or Aspirin

  • Show any signs of an infection, such as fever or chills

  • Are pregnant or think you might be

  • Currently have any skin conditions including: rash, infections, or open sores
  • What to Expect

    You might be asked to lie flat on your stomach with a pillow under your head and one under your hips. Otherwise, you might be asked to lie on your side with a pillow under your head and one between your knees. The doctor will clean your skin with a special soap. Local anesthetic will be injected into the skin of your back at the site to be treated. When the area is numb, a needle is placed and guided by x-ray into the epidural space. Dye is slowly injected. This will show up on the x-ray and will verify the needle is in the epidural space. The doctor will then inject the medicine slowly. You may feel pins and needles in the legs, pressure in the area being injected, or get a headache. Tell the doctor if you have any of these or other feelings.

    After the Injection

    We will check your blood pressure. You will be assisted off the procedure table and into the restroom. You will need to urinate before leaving. We ask that you have someone who is able to drive you home after the procedure.

    Possible Side Effects

    For 12 to 24 hours after the injection, you may have pain or bruising at the site of the needle insertion. If this occurs, apply an ice pack for 10-15 minutes every hour to help relieve the pain. Over the counter pain medicine may also be helpful.

    Other side effects from the injection may include:


  • A temporary increase in pain that eases again in 24-36 hours

  • A headache from leakage of the spinal fluid or from injection of air into the spinal fluid. In most cases the headache goes away within a few hours but it can last for a few days. Call your doctor if the headache does not ease.

  • A hot flushed feeling or a rash from a reaction to the injection. This should get better within a few hours or days.
  • You may have side effects from the steroid medicine. These may include:


    • Weight gain

    • Increase in blood sugar, especially if you have diabetes

    • Water retention

    • Increase risk of infection

    When to Call


  • Any signs of infection, such as redness, swelling, fever or chills

  • Low back feels tender to touch especially near the tailbone or if the pain becomes more severe

  • Changes in muscle function, such as weakness of a leg

  • A severe sustained headache, unlike a common headache
  • Repeat Injections

    If the first injection does not give you relief, you may be scheduled to try a second injection.

    Last Updated (Monday, 26 April 2010 00:44)




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