Epidural Steroid Injection

Medically reviewed by Drugs.com. Last updated on Apr 6, 2025.

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What do I need to know about an epidural steroid injection (ESI)?

An ESI is a procedure to inject steroid medicine into the epidural space. The epidural space is between your spinal cord and vertebrae. Steroids reduce inflammation and fluid buildup in your spine that may be causing pain. You may be given pain medicine along with the steroids.

How do I prepare for an ESI?

Your provider will talk to you about how to prepare for your procedure. He or she will tell you what medicines to take or not take on the day of your procedure. You may need to stop taking blood thinners or other medicines several days before your procedure. You may need to adjust any diabetes medicine you take on the day of your procedure. Steroid medicine can increase your blood sugar level. Arrange for someone to drive you home when you are discharged.

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What will happen during an ESI?

• You will be given medicine to numb the procedure area. You will be awake for the procedure, but you will not feel pain. You may also be given medicine to help you relax. Contrast liquid will be used to help your provider see the area better. Tell the provider if you have ever had an allergic reaction to contrast liquid.
• Your provider may place the needle into your neck area, middle of your back, or tailbone area. He or she may inject the medicine next to the nerves that are causing your pain. He or she may instead inject the medicine into a larger area of the epidural space. This helps the medicine spread to more nerves. Your provider will use a fluoroscope to help guide the needle to the right place. A fluoroscope is a type of x-ray. After the procedure, a bandage will be placed over the injection site to prevent infection.

What will happen after an ESI?

You will have a bandage over the injection site to prevent infection. Your provider will tell you when you can bathe and any activity guidelines. You will be able to go home.

What are the risks of an ESI?

You may have temporary or permanent nerve damage or paralysis. You may have bleeding or develop a serious infection, such as meningitis (swelling of the brain coverings). An abscess may also develop. An abscess is a pus-filled area under the skin. You may need surgery to fix the abscess. You may have a seizure, anxiety, or trouble sleeping. If you are a man, you may have temporary erectile dysfunction (not able to have an erection).

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