If you've been dealing with persistent back pain, neck pain, or pain traveling into your arms or legs, your provider may recommend an epidural steroid injection (ESI).

Although the name may sound intimidating, epidural steroid injections are one of the most common nonsurgical treatments for spinal pain. The procedure is designed to reduce inflammation around irritated nerves, helping relieve pain and improve your ability to move comfortably.

For many patients, an epidural steroid injection provides enough relief to return to work, participate in physical therapy, or avoid surgery altogether.

What Is an Epidural Steroid Injection?

An epidural steroid injection is a minimally invasive procedure that places a corticosteroid medication into the epidural space, the area surrounding the spinal nerves.

Unlike pain medication that affects your entire body, the medication is delivered directly to the source of inflammation.

The goal is to:

• Reduce swelling around spinal nerves
• Decrease pain
• Improve mobility
• Make physical therapy more effective
• Delay or eliminate the need for surgery for some patients

What Conditions Can It Treat?

Epidural steroid injections are commonly used to treat:

Herniated Discs

A herniated disc can press on nearby nerves, causing pain, numbness, or weakness.

Read more: Herniated Disc vs. Bulging Disc
Internal Link: /herniated-disc-vs-bulging-disc

Sciatica

Inflammation affecting the sciatic nerve often causes pain that travels from the lower back into the buttock and leg.

Learn more: What Does Sciatica Feel Like?
Internal Link: /what-does-sciatica-feel-like

Spinal Stenosis

When the spinal canal narrows, nerves become compressed, causing pain while walking or standing.

Degenerative Disc Disease

Age-related changes in spinal discs can lead to inflammation and chronic pain that may respond well to targeted injections.

Pinched Nerves

Inflamed nerve roots in the neck or lower back often improve after inflammation is reduced.

What Happens During the Procedure?

The procedure usually takes 15 to 30 minutes.

Most patients remain awake throughout the injection.

Your physician will:

• Clean the treatment area
• Numb the skin with a local anesthetic
• Use X-ray guidance (fluoroscopy) to precisely position the needle
• Inject a combination of steroid medication and anesthetic around the affected nerve

After a short observation period, most patients are able to go home the same day.

Does the Injection Hurt?

Most patients report only mild discomfort.

You may feel:

• Pressure
• Brief stinging from the numbing medicine
• Temporary soreness afterward

Because the procedure is performed using imaging guidance, it is both accurate and designed to minimize discomfort.

How Long Does It Take to Work?

Some people notice improvement within 24 to 48 hours, while others experience gradual relief over several days.

The steroid medication needs time to reduce inflammation, so immediate relief isn't always expected.

How Long Does Pain Relief Last?

Results vary depending on the underlying condition.

Pain relief may last:

• Several weeks
• Several months
• Longer for some patients

For many individuals, injections provide enough relief to allow participation in physical therapy and other treatments that improve long-term outcomes.

Are Epidural Steroid Injections Safe?

When performed by experienced specialists using imaging guidance, epidural steroid injections are generally considered safe.

As with any medical procedure, potential risks include:

• Temporary soreness
• Infection (rare)
• Bleeding (rare)
• Headache
• Temporary numbness

Your physician will discuss the risks and benefits based on your medical history.

When Should You Consider an Epidural Steroid Injection?

Your provider may recommend one if:

• Pain persists despite conservative treatment
• Pain radiates into your arms or legs
• Physical therapy alone isn't enough
• You want to delay or avoid surgery
• Pain is limiting work or daily activities

Not every patient is a candidate, which is why a thorough evaluation is important.

Frequently Asked Questions

What is an epidural steroid injection used for?

It helps reduce inflammation around irritated spinal nerves caused by conditions such as herniated discs, sciatica, and spinal stenosis.

Does an epidural steroid injection hurt?

Most patients experience only mild discomfort, and the area is numbed before the injection.

How long does pain relief last?

Relief varies but often lasts several weeks to several months.

Will I be asleep during the procedure?

Most patients remain awake. A local anesthetic is used to keep the procedure comfortable.

How many injections can I receive?

Your physician will determine the appropriate number based on your condition and response to treatment.

Can an epidural steroid injection prevent surgery?

For many patients, injections provide enough pain relief to delay or avoid surgery, although results vary.

When can I return to normal activities?

Most patients resume light activities the following day unless instructed otherwise.

Is physical therapy still important after an injection?

Yes. Pain relief often allows patients to participate more effectively in rehabilitation, helping improve long-term outcomes.