What is an epidural steroid injection?
This is an injection of steroids into the space around your spinal cord. The nerves to your arms and legs pass through an area in your spine called the ‘epidural space’. These spinal nerves can become inflamed due to irritation from a damaged disc or from contact with a bone spur causing backache. These injections can go in your neck (Cervical), back (thoracic/lumbar) or tailbone (caudal).
Why do I need an epidural steroid injection?
You have lower body, back, leg (sciatica) or arm pain. The injection is usually done to relieve pain and swelling that may not have been treated by a spinal nerve root injection. The injection is not a cure. It may be given alongside physiotherapy and other supporting treatments.
How do I get an epidural steroid injection?
This procedure can be covered by either the NHS or privately. Orthopaedic, neurosurgical or pain management consultants can offer this procedure. The injection is usually done in a day case ward or centre.
You can find a consultant surgeon using the search function on our website . Even though it’s done privately, it’s still important to let your GP know you’re thinking about having a pain control.
What is injected?
- A local anaesthetic to help numb the skin
- A steroid to help reduce inflammation
- A dye that is only visible on x-ray
The steroid needs time to reduce inflammation. This can take up to 6 weeks. Pain may return. You may require more than one injection or other treatments.
How do I decide on an epidural steroid injection?
You’ll have an initial consultation with a consultant surgeon to talk about what types and locations the injection might be suitable for you. Other treatment options will be discussed with you before deciding to have the epidural injection and your consent is needed. The decision on whether to have the injection is made together by you and your doctor.
What happens during the injection?
You will be shown to a cubicle by a member of your healthcare team where you will be asked to undress in private and put on a gown.
You will lie on your front. The epidural procedure takes 10-20 minutes. Local anaesthetic is injected into the skin. A fine needle is guided towards the epidural space using x-ray or ultrasound. Then the local anaesthetic and steroid are injected.
You will be monitored after the procedure. Sometimes you will be asked to lie flat for about 30 minutes or longer. You will be told when to get dressed and be helped to make sure you can stand safely after the procedure. You may be advised to not drive and should arrange for someone to collect you.
Recovery and what to expect after an injection
The following is only a guideline, your surgeon will advise you on how long your own recovery might expect to take.
Your back may feel sore near the injection site. You should be able to complete your normal activities.
- Day 1: You may feel some immediate pain relief from the local anaesthetic.
- Day 2: Remove the dressing if used.
- Week 1: You can resume normal exercise and heavy lifting.
- Week 2: Week 6: You pain may vary as the steroid takes effect.
What are the potential effects of an epidural injection?
All surgical procedures carry some risk of complications. Here are some of the most common complications associated with a epidural steroid injection.
- Bleeding and bruising
- Damage to the lining around the nerve which may cause a severe headache for a few days.
- Facial flushing for a few days.
- Temporary disruption to your menstrual cycle.
- If you are diabetic, then the steroids may raise your glucose levels.
More serious complications include allergic reactions to the anaesthetic, infection at the injection site or difficulty emptying your bladder.
Epidural steroid injection treatments do not always work and may not help your pain.
You’ll be given information on what to look out for and what to do if you develop any complications. Your doctor can also tell you how likely they are to affect you.
How effective are epidural steroid injections?
For spinal or arm/leg (radicular pain) lasting longer than three months, epidural steroid injection is not recommended by the British Medical Journal.
How much does an epidural injection cost?
As a surgical procedure, you can get an epidural steroid injection funded through either private medical insurance or self-fund.
Epidural steroid injection costs in the UK vary. Costs of different techniques will also differ.
Typically, an initial consultation with the consultant will cost between £100 and £250, depending on where you live. If you move forwards with the procedure, you’ll be offered one of the following.
- An all-inclusive ‘ package price’ , where you know the full costs before undergoing treatment. Typically, this can range from £2,000-£3,000. Not all consultants and hospitals offer this.
- A ‘ fee-per-service ’ deal, where you receive different invoices from the surgeon, the anaesthetist and the hospital. You often won’t know the full costs until you receive the invoices.
For more information, you can read our guide on self-pay .
