What is an epidural steroid injection?
An epidural steroid injection is a procedure where steroid medication is injected into the epidural space around the spinal cord. The epidural space is the area between the outer covering of the spinal cord and the vertebrae. Steroids help reduce inflammation which can provide pain relief. Epidural steroid injections are commonly used to treat low back pain and radicular pain from a herniated disc or spinal stenosis. They can provide both diagnostic information and therapeutic pain relief.
How is an epidural steroid injection performed?
Epidural steroid injections are performed by an interventional pain specialist, such as an anesthesiologist. The procedure is done using x-ray guidance (fluoroscopy) to ensure proper needle placement. You will be laying on your stomach and a local anesthetic will be used to numb the injection area. The doctor will insert a needle into the epidural space and inject the steroid medication. Sometimes a steroid mixed with a numbing medication, called a transforaminal epidural, is injected near the nerve root for better targeted delivery. The entire procedure takes about 10-15 minutes.
What happens after the injection?
Right after the injection you will remain lying down for up to 30 minutes or longer to allow the medication to fully spread. You may feel some tingling or numbness temporarily in your legs or back from the local anesthetic. You can generally resume normal activity the same day but you may feel sore for a day or two. Follow your doctor’s instructions about resuming activity. Avoid strenuous physical activities for 1-2 days. Use ice on the injection site for 20 minutes a few times a day to help with any discomfort. Take over-the-counter pain medication as needed.
Do you need to rest after an epidural steroid injection?
Many patients wonder if they need to rest and limit activity after receiving an epidural steroid injection. Here are some general guidelines:
Day of injection:
– Take it easy the rest of the day after your injection. Avoid any strenuous activity and resume normal activity gradually.
– Do not drive for several hours after the procedure due to the numbing medication.
– Use ice on the injection site as needed for discomfort.
– You may experience some localized back or leg soreness for a day or two.
First 2 days after injection:
– Avoid any heavy lifting, bending or twisting that puts strain on your back. Do not lift anything over 10 pounds.
– Avoid prolonged sitting or standing in the same position. Take regular short walks and stretch breaks.
– Do not participate in exercise classes or sports. No high impact activities.
– You can generally resume deskwork and light household chores. Just go slow and listen to your body.
3-5 days after injection:
– You should be able to resume most normal activities but continue avoiding strenuous physical activities that strain your back.
– No heavy lifting over 20 pounds. Avoid repetitive bending and twisting.
– Low impact exercise like walking is encouraged to promote healing.
– If you have a job with physical demands, you may need to be on light duty for 5-7 days. Discuss with your doctor.
1 week after injection:
– You can generally resume your full normal activities at this point including regular exercise routines. Avoid suddenly overdoing activities.
– Still proceed with care and avoid anything that causes increased pain. Let pain be your guide.
– You should start feeling pain relief setting in from the steroid medication within 1-2 weeks.
Conclusion
While complete bed rest is not necessary, it is recommended to take it easy and limit strenuous physical activities for at least the first 5 days after an epidural steroid injection. This allows the body time to start absorbing the medication and lets any inflammation from the injection settle down. Gradually increase activity over a week as tolerated. Avoiding re-injury or aggravation is key during the period when the steroid is starting to take effect to provide optimal pain relief. Discuss your specific activity restrictions with your doctor and follow their advice closely for proper healing. With a little patience and short-term activity modification, an epidural steroid injection can provide significant back and leg pain improvement.
Frequently Asked Questions
How long does it take for the steroid to work?
It can take 1-2 weeks to feel the full effects of the steroid. Some patients experience pain relief within a few days while for others it takes the full 2 weeks to get the maximum benefit.
What are the risks of an epidural steroid injection?
Risks are low when performed by an experienced doctor. Possible risks include bleeding, infection, nerve injury, and side effects from the steroid. Serious complications are rare.
How many injections are needed?
Some patients only need 1 injection for sufficient pain relief while others may require 2 or 3 injections spaced out by several weeks. This depends on your diagnosis and severity of symptoms. Discuss with your doctor.
Can I go back to work the next day?
Most patients can return to light work duties the day after the injection. You may need to avoid heavy physical work for up to a week. Discuss with your doctor based on your job requirements.
When can I start physiotherapy?
Follow your doctor’s recommendations, but most patients can resume physiotherapy within 2-3 days after the injection as long as activities are kept gentle without straining the back.
Tips for recovering after an epidural steroid injection
Here are some tips to help promote healing and recovery after an epidural steroid injection:
| Tip | Details |
|---|---|
| Rest and take it easy | Avoid strenuous activity and get plenty of rest the first few days. Let your body start to heal. |
| Use cold therapy | Ice the injection site for 15-20 minutes a few times a day to reduce inflammation. |
| Watch your posture | Be mindful of posture and body mechanics to avoid straining your back. Maintain good spinal alignment. |
| Stretch gently | Gentle stretches can help reduce stiffness and prevent muscle tightness. Avoid over-stretching. |
| Consider physical therapy | Seeing a physical therapist can guide you through proper recovery exercises and techniques after the injection. |
| Stay active | Light walking and activity helps circulation and prevents stiffening up. Just avoid straining the back. |
| Watch your limits | Increase activity slowly. Avoid anything that causes increased pain as a sign to back off. |
| Hydrate | Drink plenty of fluids to stay hydrated which aids healing. |
Conclusion
While an epidural steroid injection is designed to reduce inflammation and provide pain relief, proper rest and recovery afterwards are still important. Avoiding re-injury or overuse of the spine in the days following the injection allows the medication time to take effect and the procedure site to heal. Being mindful of body mechanics, limiting strenuous activity, using ice therapy, staying hydrated, and gradually increasing normal activity are all recommended after an epidural steroid injection procedure. With some short-term activity modifications and patience, an epidural can get you on the road to feeling better.
