• Spinal Corticosteroid Injection

    (Spinal Steroid Injection; Epidural Steroid Injection)


    A spinal corticosteroid injection is a needle injection in the back used to relieve pain or inflammation. Corticosteroids are injected into the epidural space around the spinal nerve roots of the cervical, thoracic, or lumbar portion of the spine, depending on the area that being treated.

    Reasons for Procedure

    The 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
    Spinal injections are typically done when pain is not relieved by:
    • Rest
    • Ice and heat therapies
    • Medications
    • Physical therapy
    • Back exercises
    • Changes to the physical setup of the work environment
    • Changes to physical activities, including work
    • Spinal manipulation

    Possible Complications

    Problems from the procedure are rare, but all procedures have some risk. Your doctor will review potential problems, like:
    • Headache
    • Allergic reaction to the medication
    • Bleeding
    • Infection
    • Nerve damage
    • Fainting
    Some factors that may increase the risk of complications include:
    • Current infection
    • Certain pre-existing medical conditions
    • Treatment with blood thinners or certain other medications
    • Poor health

    What to Expect

    Prior to Procedure

    You 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
    Talk to your doctor about your medications. You may be asked to stop taking some medications up to 1 week before the procedure.


    A 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 Procedure

    You 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.
    Corticosteroid Injection
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    How Long Will It Take?

    The procedure will take less than 1 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 Care

    At 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
      • Headaches
      • Trouble sleeping
      • Facial flushing
      • Hiccups
      • Lightheadedness from low blood pressure
    At Home
    When you return home after the procedure, do the following to help ensure a smooth recovery:
    • Rest on the day of the procedure.
    • Apply ice packs for soreness at the injection site.
    It will take a few days to a week for the medication to reduce the inflammation and pain. You should be able to resume your regular activities the day after the procedure. You should be able to start exercising within 1 week.

    Call Your Doctor If Any of the Following Occur

    Complications may vary depending on the portion of the spine that receives the injection. Contact your doctor if your recovery is not progressing as expected or you develop complications such as:
    • Severe pain
    • Headache that worsens when you sit or stand and improves when you lie down
    • 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 5 pounds
    If you think you have an emergency, call for medical help right away.


    American Association of Neurological Surgeons http://www.aans.org

    Ortho Info—American Academy of Orthopaedic Surgeons http://www.orthoinfo.org


    Canadian Orthopaedic Association http://www.coa-aco.org

    Canadian Orthopaedic Foundation http://www.canorth.org


    Boswell MV, Trescot AM, et al. Interventional techniques: evidence-based practice guidelines in the management of chronic spinal pain. Pain Physician. 2007 Jan;10(1):7-111. Available at: http://www.painphysicianjournal.com/current/pdf?article=Nzcz&journal=31

    Epidural steroid injections. Know Your Back website. Available at: https://www.spine.org/KnowYourBack/Treatments/InjectionTreatmentsforSpinalPain/EpiduralSteroidInjections.aspx. Updated July 17, 2009. Accessed May 16, 2017.

    Lumbar epidural steroid injections. Beverly Pain Management website. Available at: http://www.pain-clinic.org/page-6.html. Accessed May 16, 2017.

    Manchikanti L, Staats PS, et al. Evidence-based practice guidelines for interventional techniques in the management of chronic spinal pain. Pain Physician 2003;6:3-81. Available at: http://www.painphysicianjournal.com/current/pdf?article=MTI3&journal=14

    Spine injection. Massachusetts General Hospital website. Available at: http://www.massgeneral.org/imaging/services/procedure.aspx?id=2268. Accessed May 16, 2017.

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