Most people who are offered an epidural injection want to know two things before they agree to it. How long will I be out of action, and how long will it actually help? The short answers are “usually not long” and “it depends.” The longer answers are more useful, so here they are.
If you want the basics of the procedure itself, who it’s for and how it’s done, start with our epidural steroid injection treatment page. This article picks up where that one leaves off: the hours, days, and weeks after the injection.
The first few hours
The injection itself is quick, and it’s done under live X-ray so the medication lands where it’s meant to. Sedation is available but not required. Afterward you’ll rest for a short while so the team can make sure you feel steady.
The injection contains two things: a numbing medicine and a steroid. The numbing medicine works right away, so many people feel better within minutes. Don’t read too much into that, in either direction. It wears off within a few hours, and some people notice their usual pain return that evening. That’s expected and doesn’t mean the injection failed.
The numbing medicine can also leave a leg feeling heavy or weak for a couple of hours. Plan on a ride home rather than driving yourself, and you must have one if you had sedation.
Days one to five: the slow part
The steroid is the part that does the lasting work, and it isn’t fast. It usually takes about three to five days to start calming the inflamed nerve, and for some people closer to a week. The day or two after the injection can actually feel a little worse, with soreness at the injection site or a temporary flare of the familiar pain.
Most people go back to normal daily activity the next day. Ease back in rather than testing yourself with heavy lifting or a long run. A cold pack on the injection site for 15 to 20 minutes at a time helps with local soreness, and your physician will tell you which pain relievers are fine to take.
A few short-lived side effects are common enough to know about in advance:
- Higher blood sugar. If you have diabetes, expect readings to run high for a few days. Check more often than usual and call your diabetes provider if they climb well beyond your normal range.
- Facial flushing or feeling warm, usually for a day or two.
- Trouble sleeping or feeling restless, which steroids can cause for a night or two.
These settle on their own. They’re a nuisance, not a warning sign.
How long does the relief last?
This is the honest part. Relief from an epidural injection ranges widely, from a few weeks to several months, and some people get longer than that. A smaller group gets little benefit at all. Nobody can promise you a number in advance.
A few things tend to tilt the odds. Injections generally work best for leg pain caused by an irritated nerve root, the kind of pain described in our article on sciatica vs. piriformis syndrome, and less well for back pain alone. Newer symptoms often respond better than pain that has been building for years. And what you do with the relief matters a lot.
That last point is the one patients most often miss. An epidural doesn’t repair a disc or widen a narrow spinal canal. What it does is calm the inflammation enough that you can move, sleep, and do physical therapy without fighting your pain every step. People who use that window to rebuild strength and change the habits that aggravate their back tend to keep their gains longer.
What if it doesn’t work, or wears off?
If the first injection helps for a good stretch and then fades, repeating it is often reasonable. Physicians usually limit how many steroid injections you receive in a year, because steroid exposure adds up, so the timing gets planned rather than scheduled automatically.
If the first injection does little or nothing, that’s useful information too. It may mean the nerve root wasn’t the main source of pain, and that a different explanation or a different approach deserves a look, rather than simply trying the same thing again. Your physician will talk through what the result means and what comes next. Our page on low back pain and sciatica treatment covers the other options, from targeted nerve procedures to spinal cord stimulation.
When to call us, and when to go to the ER
Call the office if you have a headache that gets worse when you sit or stand and eases when you lie down, redness or swelling at the injection site, or new pain that’s clearly different from your usual pain.
Go to an emergency department right away for fever with back pain, new leg weakness or numbness that is getting worse, loss of bladder or bowel control, or numbness in the groin or inner thighs. These are rare after an epidural, but they’re the reason it’s worth knowing the list.
Thinking about an epidural?
An injection works best as part of a plan, not as a standalone fix. If you’ve been dealing with leg or back pain and want to know whether an epidural makes sense for you, our physicians can help you decide. If it’s your first visit, here’s what to expect at your first appointment.
ReclaimAbility Pain Services sees patients at our Mount Laurel, Haddonfield, Washington Township, and Linwood offices. Request an appointment or call 855-727-2465.
This article is for general education and is not a substitute for a medical evaluation. Follow the specific instructions your physician gives you after any procedure.
