A cortisone shot in the back, typically an epidural steroid injection (ESI) or a facet joint injection, delivers powerful anti-inflammatory medication directly to the source of pain. This procedure alleviates symptoms like radiating leg or arm pain caused by conditions such as spinal stenosis, herniated discs, or inflamed nerve roots. A local anesthetic is often included with the corticosteroid to provide immediate, temporary pain relief while the steroid targets inflammation around the spinal nerves. Due to the nature of these medications, the immediate answer to driving is clear: No, you cannot drive immediately after receiving a cortisone shot in the back.
Immediate Post-Procedure Driving Restrictions
Driving is strictly prohibited immediately following a spinal injection because medications temporarily impair motor control and cognitive function. The primary factor is the local anesthetic, or “numbing agent,” injected near the nerves. This medication is designed to block pain signals, but it can also affect the motor nerves controlling the legs. This temporary nerve block may result in noticeable numbness or weakness in the lower extremities, particularly in the legs and feet. Since safe driving relies on the ability to rapidly control the accelerator and brake pedals, any compromise to strength or reaction time makes operating a vehicle unsafe.
A secondary factor is the potential use of mild sedation during the procedure to help the patient relax. Sedative medications, even in small doses, significantly impair mental status, judgment, and coordination. These effects diminish the driver’s ability to maintain focus and react quickly to traffic situations. Therefore, patients must arrange for a responsible adult to drive them home after the procedure. This mandatory restriction applies regardless of whether sedation was used, as patients need a companion who can monitor them and assist if side effects arise.
Factors Influencing Safe Driving Clearance
The immediate driving ban is mandatory, but the timeline for resuming driving is an individualized decision guided by recovery and the specific procedure. Most facilities advise patients to avoid driving for a minimum of 12 to 24 hours following the injection. This period allows sufficient time for the effects of the local anesthetic and any sedatives to completely wear off.
The specific type of injection influences clearance, particularly whether the shot was administered in the lumbar (lower back) or cervical (neck) spine. Lumbar injections carry a greater risk of temporary leg weakness due to proximity to nerves controlling lower body movement, directly impacting pedal control. Cervical injections do not affect the legs but can cause temporary dizziness or balance issues that compromise driving safety.
Before driving is safe, two criteria must be met: the full return of sensation and strength to the lower body, and clearance from the medical provider. The patient must be able to perform an emergency stop maneuver without hesitation or discomfort, ensuring control over the vehicle. Patients must strictly follow the specific instructions provided by the treating physician, as protocols vary based on medication dose and facility policy. If delayed or unexpected side effects, such as persistent sensorimotor impairment, occur, the patient must not drive and should consult their provider.
Common Temporary Post-Injection Symptoms
Beyond the immediate effects prohibiting driving, patients may experience common, temporary symptoms in the hours and days following the injection. The most frequent symptom is localized soreness or bruising at the injection site, a normal reaction to the needle passing through the skin and muscle. Applying a cold compress can help manage this tenderness.
A temporary increase in pain, often referred to as a “steroid flare,” can occur as the local anesthetic wears off, typically 12 to 24 hours after the procedure. This is not a sign that the injection failed, but rather a short-term reaction that usually resolves within a few days. Over-the-counter pain relievers, if approved, can manage this discomfort until the anti-inflammatory effects of the cortisone begin to work.
Systemic side effects may also manifest, including facial flushing or feeling warm, which is a temporary hormonal response to the corticosteroid. Patients may also report temporary insomnia, restlessness, or mild headaches. For individuals with pre-existing conditions, the steroid can temporarily increase blood sugar levels in diabetics or elevate blood pressure in hypertensive patients, requiring close monitoring.
While most symptoms are minor and resolve quickly, patients must be aware of signs that warrant immediate medical attention. These rare but serious symptoms require urgent contact with the healthcare provider:
- A high fever, or significant redness or drainage at the injection site.
- Severe, persistent headaches that do not improve.
- New or worsening weakness or numbness in the legs.
- A loss of bowel or bladder control.