What to Expect During an Epidural Steroid Injection Procedure

Doctors sometimes prescribe an epidural steroid injection as a conservative treatment for back pain. If your doctor has recommended that you have this treatment, you may have a few questions and concerns. Will it hurt? Is it scary? Do I need iv sedation? Will it help? How long will it last?

In this article, I hope to answer these questions and describe the process from a first-hand patient's perspective. I have had multiple steroid injections in an effort to relieve L5/S1 lumbar spine pain caused by degenerative disc disease and disc herniation.

Only your doctor can prescribe this treatment and it may not be suitable for everyone.

What Can I Expect During the Procedure?

A doctor performs the injection in a sterile environment as an outpatient procedure. It may take place in a hospital or a clinic. A nurse assists the doctor by running the fluoroscope and making sure that you are comfortable. The procedure only lasts about 10 to 15 minutes. Your time spent in the waiting room is often longer!

The fluoroscope is a special type of x-ray that the doctor uses to position the needle correctly. It does not hurt. You should be able to see a small computer monitor which shows you the fluoroscope image of your back during your procedure. I even asked my doctor for a printout of my spine for my records.

You will need to change into a gown so the doctor can reach the correct area of your back. Once in the fluoroscope room, you will lay face down on a table on your stomach. There may be special armrests above your head that you can grasp. (Grasping them seems to keep your nerves at bay while keeping your arms free from your back area.)

The doctor will most likely chat with you while preparing the medications to be injected into your back.

Will the Epidural Steroid Injection Hurt?

No, because the doctor will first administer a local anesthetic such as lidocaine. The anesthetic will sting and burn but the sensation is over quickly. For me, it felt much like a bee sting. Depending on your pain tolerance, you may feel more or less pain but it does not last.

Once the area is numbed, the doctor will use the fluoroscope in order to administer the steroid medication in just the right place. This process does not hurt although it may feel a bit strange. I felt some pressure sensations and tingling in the lower back and buttock. It is a very quick process. The nurse will check the area, apply a Band-Aid, and send you on your way with information on potential side effects.

Potential side effects are rare but you will be instructed to watch for fever, redness, or bleeding.

You will need someone to drive you home after the procedure.

Should I Have IV Sedation?

If you're very nervous about the procedure you should talk to your doctor. Some patients do require IV sedation for this minor procedure. If you do need IV sedation, the whole process will take longer and you must have someone drive you home.

I believe it is normal to have some nervousness before having this procedure. However, it is a tolerable procedure and, in my opinion, hurts less than some dental procedures.

Will an Epidural Steroid Injection Make Me Feel Better?

Hopefully, yes. Some people feel very quick pain relief and others never do. You should begin to feel some relief within a few days of the procedure. In my case, I felt relief in my L5/S1 lumbar spine within about 2 days. Each person will experience individual results with how long the pain relief lasts or does not last.

You should be careful not to overdue it just because the injection makes you feel better. You don't want to make your injury worse! Try taking it easy and do physical therapy or yoga as prescribed by your doctor. The goal is to heal without surgery, and it may you take weeks or months to heal completely.

You may find it beneficial to have a series of 3 epidural steroid injections. However, if the first injection did not provide you with relief, then it is unlikely that an additional injection will provide relief.