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Sciatica Epidural Steroid Injection – How They Work, Benefits And Risks

Sciatica epidural steroid injections are often an excellent approach to minimize or even entirely eliminate sciatica pain and return to regular activities. Sciatica epidural steroid injections (ESIs) are a popular therapeutic option for various lower back and leg pain conditions. They've been around for a while and are an essential element of the nonsurgical treatment of sciatica and lower back pain.

An epidural steroid injection is so termed because it involves injecting a local anesthetic and steroid medicine directly into the epidural area surrounding the spinal cord and nerve roots.

Epidural steroid injections may aid in managing inflammation and discomfort caused by one or more spinal motion segments.

An epidural steroid injection aims to manage pain by lowering inflammation in and around the nerve roots, improving mobility and function in the lower back and legs, and enabling the patient to engage in and develop a physical therapy and rehabilitation program.

In most circumstances, an epidural steroid injection may be advised during one's care program after several non-surgical therapies, such as drugs and physical therapy, have been attempted and before surgery is contemplated.

The injection's function typically offers enough pain relief to enable a return to daily activities and progress in physical therapy.

What Is Sciatica?

Sciatica is not only painful, but it may also be crippling. It may have an impact on your everyday life if not appropriately addressed. Even basic tasks like sitting or walking may be uncomfortable, and pain might flare up, causing more immobility.

The most frequent cause of sciatica pain is a pinched nerve in the lower back. The sciatic nerve is the body's biggest nerve, stretching from the lower back to the back of each leg. Sciatica occurs when the nerve in the lower back is crushed or inflamed by surrounding tissues such as discs or bones. This causes discomfort, tingling, and numbness in your lower back, hips, buttocks, and legs.

A male doctor pointing a human skeleton to show the spinal cord
A male doctor pointing a human skeleton to show the spinal cord

Sciatica Pain Causes

You may believe that the discomfort in your lower back is transient and that you may ignore it. However, you should be aware that sciatica pain might be caused by a herniated lumbar disc, which is a severe problem for you. Your discs, placed between your spine's bones, might wear out and split, causing them to protrude or herniate. Pinched nerves will ensue if this occurs.

A narrowing of the spinal canal, known as spinal stenosis, may also cause sciatica because it compresses and puts pressure on all the nerves that exit your back and go down your legs. Degenerative disc degeneration and aberrant bone spurs on the vertebrae are two more reasons.

So don't expect your lower back discomfort to go away for a minute. See your doctor, particularly if the pain exacerbates and prevents you from doing your typical responsibilities.

Epidural Steroid Injection For Sciatica Pain

While mild sciatica pain might cure on its own with rest and care or pain medication, severe or persistent cases may need more invasive therapy, such as surgery.

However, most people dislike surgery, mainly when it involves spinal nerves. Many people resort to lumbar epidural steroid injections as a non-surgical alternative for treating sciatica pain in the lower back and legs.

The injection's objective is to offer relief from sciatica discomfort. However, its pain alleviation is usually very transient. For some, it lasts just a week, while for others, it provides them with a year of pain-free living. The outcome varies according to the origin and degree of sciatica pain.

But one thing is sure: epidural steroid injections relieve short and long-term pain. It's certainly worth a shot. Epidurals are very effective for people experiencing acute back or leg discomfort. It may give enough pain relief for rehabilitation patients to continue with this form of treatment.

Procedure For Sciatica Epidural Steroid Injection

Epidural steroids are injected directly into the lumbar region, where the discomfort originates. It is injected into the spine's epidural area. A topical anesthetic and a saline solution may be utilized to treat the inflammation that is generally causing the discomfort.

A typical epidural mixture includes a steroid (cortisone), a local anesthetic (lidocaine or bupivacaine), and a saline solution. The steroid is essentially an anti-inflammatory drug that relieves sciatica pain.

Lumbar epidural steroid injection is an outpatient operation that takes between 15 and 30 minutes to complete. Following the injection, the patient will be momentarily examined, and if everything is well, they will be sent home with the doctor's recommendations for home care.

Fluoroscopy (X-ray) will be used to guide the needle's insertion route during the process. After that, the injection will be administered into the epidural space. X-rays are necessary to guarantee that medicine is delivered directly to the treatment site.

Benefits Of Sciatica Epidural Steroid Injection

Most practitioners agree that an epidural injection may be therapeutic during an acute back and/or leg pain. The primary disadvantages of the injections are that they are not always successful, and even when they are, the pain relief is very brief, lasting anywhere from one week to a year. If the first injection is beneficial, up to three injections may be administered in a year.

Steroid injections in the lumbar epidural space may have the following benefits:

  • Steroids lower inflammatory chemical production and nerve fiber sensitivity to pain, resulting in fewer pain signals.
  • The pain relief provided by these injections may reduce or eliminate the requirement for oral medications, four of which may have adverse effects when used long-term.
  • This injection may give enough pain relief to enable a patient to continue with rehabilitative physical therapy.
  • Pain reduction by lumbar epidural steroid injections may delay surgery, and if physical therapy is adequate, it may avoid surgery.
Drawing of human lower back and legs with red and green lines starting from the backbone and going inside legs
Drawing of human lower back and legs with red and green lines starting from the backbone and going inside legs

Risks For Sciatica Epidural Steroid Injection

Epidural steroid injections are regarded as reasonably safe and less intrusive procedures. In certain situations, temporary side effects may develop, including (but are not limited to):

  • Injection discomfort.
  • Nausea
  • Headache
  • Dizziness
  • Weakness (vasovagal attack)
  • Flushing of the cheeks

These adverse effects usually go away within a few minutes to hours. While serious consequences are uncommon, they may include spinal cord injury, dural puncture, and/or stroke.

In general, epidural injections at spinal levels L4 or below have a reduced risk of complication(s) than higher levels. Fluoroscopy (x-ray guidance) is often used to administer the injections using a contrast dye. Fluoroscopy aids in correctly placing the needle and preventing and/or artery injury.

When specific aggravating medical problems, such as infections, tumors, or bleeding disorders, are present, the injections are usually avoided. Furthermore, the injections may not be administered if the patient has uncontrolled diabetes, certain cardiac diseases, or is pregnant.

People Also Ask

How Painful Is A Lumbar Epidural Steroid Injection?

Are epidural steroid injections uncomfortable? A local anesthetic is injected into the skin to numb the region where the epidural needle will be inserted. Patients may suffer slight discomfort but should not experience extreme pain during the process.

How Successful Is Epidural For Sciatica?

A study of multiple major clinical studies found that when 1 to 4 injections were administered throughout a year, 40% to 80% of patients achieved more than 50% improvement in sciatica pain and functional result from 3 months to 1 year.

How Long Does An Epidural Steroid Injection Last?

The steroid works on the inflamed nerve(s), causing discomfort, and reducing swelling and nerve pressure. Lumbar epidural steroid injections often alleviate temporary pain that lasts three months or more. However, some patients may receive less or no pain relief.

Does Epidural Steroid Injection Help Sciatica?

Epidural steroid injections for sciatica are often an excellent approach to lessen or even eliminate sciatica pain. This allows you to return to your regular activities.


Using sciatica epidural steroid injections relieves pain and allows you to work out. The combination of injections and the proper workouts relieves your pain for much longer. Exercise routines concentrating on lower back stretches and light strength training often perform best. Strengthening your hip and core muscles may help relieve sciatic nerve discomfort.

Consult your physical therapist to develop the best fitness program for you. The last thing you want is to overdo it and injure your lower back. However, with injections and exercise, your sciatica pain will no longer interfere with your everyday life.

About The Authors

Suleman Shah

Suleman Shah - Suleman Shah is a researcher and freelance writer. As a researcher, he has worked with MNS University of Agriculture, Multan (Pakistan) and Texas A & M University (USA). He regularly writes science articles and blogs for science news website immersse.com and open access publishers OA Publishing London and Scientific Times. He loves to keep himself updated on scientific developments and convert these developments into everyday language to update the readers about the developments in the scientific era. His primary research focus is Plant sciences, and he contributed to this field by publishing his research in scientific journals and presenting his work at many Conferences. Shah graduated from the University of Agriculture Faisalabad (Pakistan) and started his professional carrier with Jaffer Agro Services and later with the Agriculture Department of the Government of Pakistan. His research interest compelled and attracted him to proceed with his carrier in Plant sciences research. So, he started his Ph.D. in Soil Science at MNS University of Agriculture Multan (Pakistan). Later, he started working as a visiting scholar with Texas A&M University (USA). Shah’s experience with big Open Excess publishers like Springers, Frontiers, MDPI, etc., testified to his belief in Open Access as a barrier-removing mechanism between researchers and the readers of their research. Shah believes that Open Access is revolutionizing the publication process and benefitting research in all fields.

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