Epidural Steroid Injection (Lumbar, Thoracic, Cervical Injection)

Epidural injections are given to manage pain during procedures (epidural nerve blocks) and to manage chronic pain (epidural steroid injections). This article discusses epidural steroid injections in particular. Steroids are a manufactured hormone that can reduce inflammation and pain. If you have arm, neck, low back, or sciatic leg pain, you may find relief from an epidural steroid injection.

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What Does Epidural Mean?

“Epidural” means on or around the dura mater, which is the tissue around your brain and spinal cord. Epidural injections are often simply called epidurals because they involve injections into this tissue.

When Procedure is Used

The nerves in your spine can become inflamed and painful because of spinal stenosis (the narrowing of the spaces within your spine) or a herniated disc (a pushing of a disc into the spinal canal). The steroid is injected into a particular space around your spinal cord to reduce inflammation caused by spinal stenosis and herniated discs, and the intended result is pain relief that can last from days to years. If you have already tried to relieve your pain with physical therapy or if you experience pain not only during regular activity but also physical therapy, an epidural steroid injection might be an option for you.

During the Procedure

You will likely be lying on an x-ray table so your doctor can use a live x-ray to place the injection as close to the affected nerve(s) as possible. You may also be given something to relax and sedate you, but you will not be given general anesthesia because staying awake allows you to give feedback to the doctor during the procure. Instead, a local anesthetic will be used to numb the area before the doctor directs a hollow needle into the epidural space between your vertebrae of your spine. If you are receiving a cervical (neck) epidural, the injection will be performed through the side of your neck. A lumbar (lower back) epidural will be performed just off the center of your spine, and a caudal (tailbone) injection is placed above your tailbone in order to access the lowest nerves in your spine. Your doctor may also perform multiple injections close to each other. After the procedure, you should be able to walk right away and will be allowed to leave a short time later. Patients are usually not able to drive themselves home, however, because of the sedation they are given just prior to the procedure, so you will want to make sure someone can take you home.


The risks are low. However, potential risks might include

  • allergic reactions to medications.
  • mild pain at the site of the injection(s)
  • side effects from the steroid itself
  • bleeding
  • infection
  • spinal headache


  • pain relief
  • a return to normal activities

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