A 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.
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
Spinal injections are typically done when pain is not relieved by:
RestIce and heat therapiesMedicationsPhysical therapyBack exercisesChanges to the physical set-up of the work environmentChanges to physical activities, including workSpinal manipulation
Complications are rare, but no procedure is completely free of risk. If you are planning to have an injection, your doctor will review a list of possible complications, which may include:
HeadacheAllergic reaction to the medicationBleedingInfectionNerve damageFainting
Some factors that may increase the risk of complications include:
Current infectionCertain pre-existing medical conditionsTreatment with blood thinners or certain other medicationsPoor health
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
X-rayMRI scanCT scan
Talk to your doctor about your medications. You may be asked to stop taking some medications up to one week before the procedure, like:
A local anesthetic and/or a sedative may be used. They may help to reduce pain and
. You will be awake for 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.
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The procedure will take less than one hour. The entire visit takes about 2-3 hours.
The injection of the local anesthetic may burn or sting for a few seconds. After that, you should not feel pain during the procedure.
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 painHeadachesTrouble sleepingFacial flushingHiccupsLightheadedness from low blood pressure
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.Ask your doctor about when it is safe to shower, bathe, or soak in water.
Be sure to follow your doctor's
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 one week.
After arriving home, contact your doctor if any of the following occurs:
Signs of infection, including fever and chillsRedness, swelling, increasing pain, bleeding, or discharge from the injection siteShortness of breath or chest painNumbness, tingling, pain, or weakness, especially in the arms, hands, legs, or feetChanges in urine or bowel functionSudden increase in weight of more than five pounds
In case of an emergency, call for medical help right away.
Epidural steroid injections. KnowYourBack website. Available at: http://www.knowyourback.org/Pages/Treatments/InjectionTreatments/ES_Injections.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.
Last reviewed November 2013 by John C. Keel, MD; Michael Woods, MD
Please be aware that this information is provided to supplement the care provided by your physician. It is neither intended nor implied to be a substitute for professional medical advice. CALL YOUR HEALTHCARE PROVIDER IMMEDIATELY IF YOU THINK YOU MAY HAVE A MEDICAL EMERGENCY. Always seek the advice of your physician or other qualified health provider prior to starting any new treatment or with any questions you may have regarding a medical condition.
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