What is an Epidural Steroid Injection?

 

An Epidural Steroid Injection (ESI) is a common procedure used to treat pain caused by inflammation around the spinal nerves. The injection delivers a combination of steroid and local anaesthetic medication into the epidural space around your spinal cord.

What conditions do we offer this for?

We offer epidural steroid injections to help manage pain caused by the following conditions:

  • Sciatica (nerve root irritation or compression)
  • Spinal stenosis (narrowing of the spinal canal)
  • Post-surgical pain following spinal surgery

Why is it done?

 

The injection aims to:

  • Reduce inflammation
  • Relieve pain
  • Improve mobility and function
  • Facilitate engagement in physiotherapy or rehabilitation

It is typically considered when other treatments like oral medications or physical therapy.

have not provided sufficient relief.

What does the procedure involve?

  • You will lie on your stomach (in most cases).
  • Your skin will be cleaned and numbed with local anaesthetic.
  • Under X-ray or ultrasound guidance (for Caudal Epidural), a fine needle is inserted into the epidural space.
  • The steroid and anaesthetic solution is slowly injected.

The procedure usually takes 15–30 minutes.

Benefits

  • Pain relief lasting weeks to months
  • Reduced need for oral pain medications
  • Improved ability to participate in physical rehabilitation
  • May delay or avoid the need for surgery

Side Effects

Very Common side effects

(may affect more than 1in 10 patients):
  • Pain & bruising at injection site
  • Temporary increase in back or leg pain
  • Facial flushing or warmth
  • Mild headache

Common side effects

(may affect up to 1in 10 patients):
  • Insomnia
  • Increased blood sugar (especially in diabetics)
  • Nausea

 Uncommon side effects

(may affect up to 1 in 1,00 patients):
  • Temporary bladder or bowel changes
  • Dural puncture headache (if spinal fluid is accidentally tapped)

 Rare side effects

(may affect up to 1 in 1,000 patients):
  • Infection at the injection site
  • Bleeding or haematoma
  • Nerve damage, paralysis
  • Allergic reaction to medication

Aftercare Advice

  • You can usually go home the same day.
  • Avoid driving for at least 12–24 hours.
  • You may experience mild discomfort for 24–48 hours after the injection.
  • Resume normal activities gradually.
  • Monitor for any new symptoms such as fever, weakness, or loss of bladder control—contact your doctor if these occur.

When to Seek Medical Attention

Seek immediate help (attend A&E) if you develop:

  • High fever or chills
  • Severe back pain not relieved by rest
  • New leg weakness or numbness
  • Difficulty passing urine or controlling bowels