Epidural Steroid Injection

Medically reviewed by Drugs.com. Last updated on Jun 30, 2025.

• Care notes
• Ambulatory
• Discharge
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AMBULATORY CARE:

What you need to know about an epidural steroid injection (ESI):

An ESI is a procedure to inject steroid medicine into the epidural space. The epidural space is between your spinal cord and vertebrae. Steroids may help relieve pain by reducing swelling and inflammation in your spine. You may be given pain medicine along with the steroids.

How to prepare for an ESI:

• Your provider will tell you how to prepare. You may be told not to eat or drink for 6 hours before the procedure. Arrange for someone to drive you home and stay with you for 24 hours after your procedure.
• Tell your provider about any allergies you have, including to medicines, contrast liquid, anesthesia, stainless steel, nickel, or titanium.
• Tell your provider about all your current medicines. You may need to stop taking blood thinners or aspirin several days before your procedure. This will help decrease your risk for bleeding. Steroid medicine can increase your blood sugar level. You may need to adjust any diabetes medicine you take. Your provider will tell you which medicines to take or not take on the day of your procedure.

What will happen during an ESI:

• You will lie on your stomach with a pillow under your pelvis. You will be given medicine to numb the procedure area. You will be awake for the procedure, but you will not feel pain. You may also be given medicine to help you relax.
• Your provider will use a fluoroscope to help guide the needle to the epidural space. A fluoroscope is a type of x-ray. Your provider may place the needle into your neck area, middle of your back, or tailbone area. Contrast liquid will be used to help your provider see the epidural space better.
• Your provider may inject the steroid next to the nerves that cause your pain.
• Your provider will remove the needle and apply pressure to the area for 2 minutes. A bandage will be put over the area to prevent bleeding or an infection.

What to expect after an ESI:

You will be taken to a room to rest. Healthcare providers will monitor you for any problems. Do not get out of bed until your healthcare provider says it is okay. When healthcare providers see that you are okay, you may be able to go home.

• A bandage will help keep the area clean and dry.
• You may feel sore around the procedure area. This should improve in a few days.
• You may not feel pain relief right away. It may take 24 to 72 hours for the steroid to work.

Risks of an ESI:

You may have temporary or permanent nerve damage or paralysis. You may have bleeding or develop a serious infection, such as meningitis (swelling of the brain membranes). An abscess (a pus-filled area under the skin) may develop. You may need surgery to treat the abscess. You may have a seizure, anxiety, or trouble sleeping. The steroid injection may not work and you may still have pain.

Related medications

Call your local emergency number (911 in the US), or have someone call if:

• You have trouble breathing.
• You have a seizure.
• You have trouble moving your legs.

Seek care immediately if:

• Blood soaks through your bandage.
• You have a fever or chills, severe back pain, and the procedure area is sensitive to the touch.
• You cannot control when you urinate or have a bowel movement.
• You have a severe headache, fever, and a stiff neck.

Call your doctor if:

• You have weakness or numbness in your legs.
• Your wound is red, swollen, or draining pus.
• You have nausea or are vomiting.
• Your face or neck is red and you feel warm.
• You have more pain than you had before the procedure.
• You have swelling in your hands or feet.
• You have questions or concerns about your condition or care.

Self-care:

• Care for your procedure area as directed. You may remove the bandage before you go to bed the day of your procedure. You may be able to shower the same day as your procedure. Do not scrub the area. Just let water run over it. Do not take a bath or swim until your healthcare provider says it is okay.
• Apply ice to the procedure area. Ice may reduce pain and swelling. Use an ice pack, or put ice in a plastic bag. Cover the bag with a towel before you apply it. Apply ice to the area for 15 to 20 minutes every hour, or as directed.
• Drink more liquids. Liquids help prevent a headache caused by dehydration and help flush out contrast liquid from your body. Do not drink alcohol. Ask how much liquid to drink each day and which liquids are best for you.
• Ask when you can return to your usual activities. Do not drive, use machines, or do strenuous activity for 24 hours after your procedure or as directed. Do not lift anything heavier than 5 pounds until your provider says it is okay. Your provider will tell you when it is safe for you to return to work, school, or other activities.
• Continue other treatments as directed. You may need to continue other treatments, such as physical therapy to help control your pain.

Follow up with your doctor as directed:

Write down your questions so you remember to ask them during your visits.

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The above information is an educational aid only. It is not intended as medical advice for individual conditions or treatments. Talk to your doctor, nurse or pharmacist before following any medical regimen to see if it is safe and effective for you.

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