What to Expect from Epidural Injections for Spinal Pain

If you’re struggling with chronic back or neck pain, your doctor may recommend an epidural steroid injection (ESI) as part of your treatment plan. This minimally invasive procedure can provide significant relief by reducing inflammation around irritated spinal nerves. Understanding what to expect before, during, and after the procedure can help ease anxiety and set realistic expectations for your recovery.

What Are Epidural Injections?

Epidural steroid injections deliver a combination of corticosteroid medication and a local anesthetic directly into the epidural space—the area surrounding the spinal cord and nerve roots. These medications work together to reduce inflammation, decrease pain, and improve mobility.

Common conditions treated with epidural injections include:

• Herniated or bulging discs

• Spinal stenosis

• Sciatica or nerve compression

• Degenerative disc disease

• Chronic lower back or neck pain

While an ESI doesn’t cure the underlying cause of pain, it can offer meaningful relief—often lasting weeks to several months—allowing patients to participate more comfortably in physical therapy or daily activities.

Before the Procedure

Before receiving an epidural injection, your pain management specialist will review your medical history and any current medications. You may be asked to stop taking blood thinners or certain anti-inflammatory medications a few days before the procedure. Let your provider know if you are pregnant, diabetic, or have any allergies to medications or contrast dye.

You’ll likely receive instructions such as:

• Avoid eating or drinking for several hours prior to the injection.

• Arrange for someone to drive you home after the appointment.

• Wear comfortable, loose-fitting clothing.

Your doctor will explain the type of epidural injection best suited for your condition—such as cervical, thoracic, or lumbar—depending on where your pain originates.

During the Procedure

The injection is typically performed in an outpatient setting and takes about 15–30 minutes. You’ll lie on your stomach or side on an X-ray table, and the area will be cleaned and numbed with a local anesthetic.

Using fluoroscopy (live X-ray guidance), your doctor will carefully guide a needle into the epidural space and inject a contrast dye to confirm proper placement. Then, the steroid and anesthetic mixture is slowly injected.

You may feel mild pressure or discomfort, but the procedure is usually well tolerated. Afterward, you’ll rest for a short time before being discharged.

After the Injection

It’s normal to experience some soreness or mild pain at the injection site for a day or two. Applying ice packs and resting can help minimize discomfort. You should avoid strenuous activity for 24 hours but can typically resume light activities the next day.

Pain relief may not be immediate. Some people notice improvement within a few days, while others may take up to a week. The effects can last anywhere from several weeks to a few months, depending on the severity and cause of your condition.

If the first injection provides partial but significant relief, your doctor may recommend a series of up to three injections spaced several weeks apart for optimal results.

Potential Risks and Side Effects

Epidural steroid injections are considered safe when performed by an experienced specialist. However, as with any medical procedure, there are some risks, including:

• Temporary pain at the injection site

• Headache

• Dizziness or flushing

• Infection (rare)

• Nerve damage or bleeding (very rare)

Serious complications are uncommon, especially when imaging guidance is used. Your provider will discuss potential risks and answer any questions you may have before proceeding.

The Benefits of Epidural Injections

For many patients, epidural injections offer significant benefits, such as:

• Reduced pain and inflammation

• Improved mobility and function

• Better tolerance for physical therapy

• Delayed or avoided need for surgery

By targeting the inflammation directly at its source, epidural injections can help restore quality of life and make it easier to stay active while healing.

When to Discuss Epidural Injections with Your Doctor

If conservative treatments like rest, medications, and physical therapy haven’t provided enough relief, an epidural injection might be the next step. Talk with your pain management specialist about your symptoms, goals, and medical history to determine if this treatment is right for you.

Epidural injections aren’t a cure, but for many people, they offer a valuable window of relief that supports long-term recovery and improved daily comfort.