Epidural steroid injections (ESIs) are a common treatment for people dealing with back pain, neck pain, or nerve-related discomfort caused by conditions like herniated discs, spinal stenosis, or sciatica.
During an ESI, a doctor injects a mix of steroids and anesthetic into the epidural space around the spinal cord. The procedure is quick with minimal discomfort, and relief typically begins within a few days.
If you’re scheduled for an ESI or have recently had one, you might be wondering what happens next. Here’s what you should expect after an epidural steroid injection, how to manage recovery, and tips to make the most of the treatment.
Right After the Injection
Once the procedure is done, you’ll typically spend a short time in a recovery area. Most people are monitored for 15–30 minutes to make sure there’s no immediate reaction to the medication. You might feel a bit woozy or lightheaded as the local anesthetic wears off, but this usually doesn’t last long.
A few common sensations include:
Numbness or Weakness
Since the injection includes an anesthetic, the area around the injection site (and possibly down your leg or arm, depending on where the shot was given) may feel numb or weak for a few hours. This is temporary and should resolve on its own.
Soreness at the Injection Site
If you feel mild tenderness or pain where the needle went in, apply an ice pack for 15 minutes at a time to reduce swelling or discomfort.
You can go home the same day, but it’s advised to have someone drive you. The effects of sedation or mild dizziness could make it unsafe for you to operate a vehicle.
The First 24 Hours
During the first day after an epidural steroid injection, be sure to take things easy. While you’re not required to stay in bed all day, it’s best to avoid strenuous activities like heavy lifting, bending, or twisting. Some people feel well enough to go back to work, but if your job involves physical labor, consider taking a day off.
- Do: Use an ice pack to soothe the injection site.
- Do: Drink plenty of water to stay hydrated.
- Don’t: Take a hot bath or use a heating pad near the injection site. Heat can increase swelling.
- Don’t: Overexert yourself. Even if you’re feeling better, give your body time to recover.
You may notice some temporary side effects, such as:
Mild Headache
This can occur if spinal fluid was accidentally punctured during the injection. It’s rare, but if you do get a headache, lying flat and drinking fluids (especially caffeine) may help.
Flushing or Warmth
Steroids can sometimes cause a brief feeling of warmth or redness in your face or chest. It usually goes away within a day.
Increased Pain
Some people report pain from epidural steroid injection in the hours immediately following the procedure. This is short-lived and may subside within a few days.
Pain Relief Timeline
The big question for most people is, “When will I feel better?” Unfortunately, there’s no one-size-fits-all answer. Here’s what you can expect in terms of a general timeline:
Immediate Relief (Rare): A few lucky people feel almost instant relief, but this is more likely due to the anesthetic rather than the steroid.
Gradual Improvement (Common): For most, the pain starts to ease 2–7 days after the injection. The steroids reduce inflammation, which takes time.
Full Effect: It may take up to two weeks to feel the maximum benefits of the injection.
Exercises After Epidural Steroid Injection
Once the soreness subsides, gentle stretching and exercises can support your recovery. Talk to your doctor or physical therapist about a safe plan for exercises after an epidural steroid injection.
Here are some simple options to follow post-epidural steroid injection:
- Walking: A low-impact activity that boosts circulation and reduces stiffness.
- Gentle Stretches: Focus on the hamstrings, lower back, and shoulders to improve flexibility.
- Core Strengthening: Strengthen your abdominal muscles to support your spine.
- Yoga or Pilates: Low-impact classes can improve posture and alignment.
Avoid anything high-impact, like running or weightlifting, until your doctor clears you.
What If Pain Persists After Epidural Steroid Injection?
Sometimes, the first injection may not provide the relief you’re hoping for. In this case, your doctor may recommend additional treatments. The next step after epidural steroid injection often depends on your specific condition and response to the procedure.
Options may include:
- Physical Therapy: Helps improve mobility and strengthen muscles to support your spine.
- Additional Injections: Some patients require a series of injections for optimal relief.
- Medications: Over-the-counter pain relievers or prescribed medications can complement the injection’s effects.
- Surgical Consultation: If non-invasive treatments don’t work, surgery may be considered as a last resort.
Your doctor will guide you through the next steps based on your progress and pain levels.
Cervical Epidural Steroid Injection: What’s Different?
If you’ve had a cervical epidural steroid injection, your recovery will be similar, though the focus will be on your neck and shoulders instead of your lower back. Some specific points to keep in mind are:
- Expect mild soreness in your neck for a day or two.
- Use a supportive pillow to avoid strain while sleeping.
- Avoid activities that involve overhead movements or prolonged computer use.
Neck pain often responds well to these injections, but the same principles of rest and gentle movement apply.
When Should You Call Your Doctor?
While complications post epidural steroid injection are rare, there are times when you should reach out to your doctor, such as:
- Severe or worsening pain that doesn’t improve
- Signs of infection like redness, warmth, or fever
- Persistent numbness or weakness in your limbs
- Severe headache that doesn’t go away with rest or hydration
These symptoms could indicate a more serious issue, so don’t ignore them.
Wrapping It Up
Epidural steroid injections are a safe and effective treatment for many people dealing with nerve-related pain. While the recovery process varies from person to person, knowing what to expect can help you feel more in control and prepared.
If you’re still unsure about the next step after an epidural steroid injection, don’t hesitate to ask your doctor. They’ll help you understand your options and create a plan that works for you. Whether it’s rest, exercise, or follow-up care, taking an active role in your recovery is key.
At Peak Health and Wellness, we specialize in providing effective, minimally invasive treatments like epidural steroid injections to help alleviate your discomfort. Our experienced team is dedicated to creating personalized pain management plans tailored to your unique needs. Get in touch with us!