While epidural steroid injections (ESIs) are generally safe, there are some potential risks, including:

• Temporary pain increase – Some patients may experience a brief increase in pain before the steroid takes effect.
• Infection – Though rare, there is a small risk of infection at the injection site.
• Bleeding – Patients with bleeding disorders or those on blood thinners may have an increased risk.
• Nerve damage – In rare cases, the needle may irritate or injure a nerve.
• Hormonal effects – Temporary changes in hormone levels due to the use of steroid medication, including mood swings, insomnia, or changes in appetite, may occur.
• Glycemic effects - temporary changes to blood glucose levels due to use of steroid medication, consult your primary care physician prior to any steroid use.
• Allergic reaction – Though uncommon, some patients may have an allergic reaction to the medication or contrast dye.

These risks will be discussed in detail during your consultation to ensure you have all the information needed before proceeding.

Epidural steroid injections (ESIs) are generally well-tolerated, with most patients experiencing only mild discomfort. The procedure involves inserting a thin needle into the epidural space, which may cause a brief pinch or pressure sensation. The needle thickness is similar to that of a flu shot. A local anesthetic is typically used to numb the area, minimizing pain during the injection. Some patients may feel temporary discomfort or mild soreness at the injection site after the procedure, but this usually subsides within a day or two. If needed, over-the-counter pain relievers such as Tylenol and applying ice can help ease any post-procedure discomfort.

Epidural steroid injections (ESIs) are an effective treatment for back pain, particularly when caused by inflammation or nerve irritation from conditions like herniated discs, spinal stenosis, or sciatica. Many patients experience significant pain relief within a few days of the procedure, with results lasting anywhere from a few weeks to several months. Patients are able to have repeat injections to maintain their pain relief over time. The effectiveness of ESIs varies from person to person. While some achieve long-term relief after one injection, others may require a series of injections or additional treatments for sustained improvement. ESIs are most beneficial when combined with physical therapy and other pain management strategies to support long-term recovery. Our goal is that you will only need 1 shot and the combined efforts with physical therapy and lifestyle modification will keep you off the procedure table in the future.

The most commonly used steroids in epidural steroid injections (ESIs) include:

• Dexamethasone – A non-particulate steroid with a lower risk of complications, often preferred for cervical injections and transforaminal injections. This is the medication we use the vast majority of the time due to its favorable safety profile.
• Betamethasone – A particulate steroid that provides effective anti-inflammatory effects.
• Triamcinolone – A particulate steroid that stays longer in the space longer due its larger particle size, offering prolonged relief but increased risk due to the larger particulates.
• Methylprednisolone – Another particulate steroid commonly used for its long-lasting effects.

The choice of steroid depends on factors such as the patient's condition, medical history, and the physician’s preference. Your doctor will determine the most suitable option for your specific needs.