Most epidural steroid injections use solutions that also contain anesthetic agents designed to provide immediate pain relief until the steroid medications have a chance to take effect. Epidural steroid injections have been used to manage low back and radiating leg pain since 1952, and prior to that, injections containing anesthetics and saline were used to help provide relief for chronic back pain.
Why are epidural steroid injections performed?
Epidural steroid injections are frequently used to relieve inflammation and pain associated with herniated discs, but they may also be used to provide relief for several other conditions that cause pain in the back or radiating down the buttocks and legs (lumbar radiculopathy), including:
- spinal stenosis, a condition that causes narrowing in the spaces between the vertebrae
- compression fractures of the low back
- spine cysts
- some types of nerve pain called neuralgia
Injections are most commonly performed in the lumbar (low back) region, but they can also be used in the thoracic (mid back) and cervical (neck) regions of the spine.
What is the injection procedure like?
Epidural steroid injections are performed as outpatients procedures, which means you can go home soon after treatment. Prior to treatment, you may receive an oral sedative to help you relax. The injection site will be carefully cleansed and a local anesthetic will be injected to numb the area. Once the numbing takes effect, a special needle will be carefully inserted into the epidural space. A special x-ray called fluoroscopy may be used to help guide placement of the needle to ensure the corticosteroid and anesthetic solution is injected in the correct place for optimal effect and relief. Once the needle’s placement is confirmed, the solution will be injected. Most procedures take under 30 minutes to complete, from start to finish.
What can I expect afterward?
Many people experience symptom relief immediately after treatment, which may be followed by a very brief recurrence of discomfort until the steroids take effect. Ice can be used to minimize any discomfort at the injection site, which may remain tender for a few days. Immediately after treatment, you’ll be taken to a recovery area to rest for about a half hour. You’ll need to have someone drive you home and you’ll also need to avoid driving, strenuous activity, hot tub use and baths for at least 24 hours after your treatment. You may shower, and the bandage can be removed before bed. If you stopped taking medication like blood thinners prior to your injection, ask the doctor when you may resume taking them. Most people resume their regular activities the next day. You’ll receive more complete discharge instructions before leaving the office.
Does insurance cover epidural steroid injections?
Most insurance companies provide coverage for epidural steroid injections, especially when performed to treat chronic pain in the lumbar area of the spine (the lower back). Some other types of epidural steroid injections may not be covered or there may be coverage limitations. Most plans limit the number of injections you can have within a specific time period. Contact your plan administrator or ask your doctor’s office staff to determine eligibility and limits under your specific plan before scheduling your treatment.