Epidural steroid injections (ESIs) are a common medical procedure used to alleviate pain and inflammation in the back and neck. These injections deliver corticosteroids directly into the epidural space, an area surrounding the spinal cord and nerves. Following an ESI, patients often have questions regarding when they can safely resume physical activities.
Immediately After Your Injection
The initial 24 to 48 hours following an epidural steroid injection are a period when rest is important. During this time, the medication begins to settle and exert its anti-inflammatory effects. Patients are generally advised to avoid strenuous activities, heavy lifting, excessive bending, or twisting movements. Limiting prolonged sitting or standing can also help reduce pressure on the injection site.
It is common to experience some mild soreness or discomfort at the injection site. Applying ice packs to the area for 10 to 20 minutes can help manage any localized tenderness.
Resuming Light Activity
After the initial 24 to 48 hours of rest, a gradual reintroduction of light activity is generally encouraged. Short, gentle walks are typically safe and beneficial for promoting circulation and preventing stiffness. Patients can start with brief walking sessions and gradually increase the duration as comfort allows. Other suitable light activities include basic daily movements and gentle stretching. It is important to listen to the body’s signals and avoid any movements that cause increased pain or discomfort.
Progressing to More Strenuous Exercise
Increasing the intensity of exercise after an epidural steroid injection should be a phased process, typically spanning several days to weeks. Moderate exercises like stationary cycling or swimming may be introduced around 3 to 7 days post-injection. These low-impact activities allow for movement without excessive strain on the spine.
For more strenuous activities such as running, heavy lifting, or high-impact sports, a more cautious approach is recommended. High-impact exercises can place significant stress on the spine and are generally to be avoided for at least two weeks, or until cleared by a healthcare provider. When reintroducing resistance training, light weights (e.g., 5-10 pounds) can be considered after the first week, with gradual increases as tolerated. A physical therapist can provide guidance on appropriate exercises and progression, ensuring proper technique to support spinal health and minimize injury risk.
When to Seek Medical Advice
While epidural steroid injections are generally safe, be aware of signs that warrant immediate medical attention. Any severe or worsening pain that does not improve, or new numbness or weakness in the buttocks or legs, should be promptly reported. A severe headache, especially one that improves when lying down, could indicate a dural puncture.
Signs of infection at the injection site, such as increased redness, swelling, unusual warmth, or discharge, require urgent evaluation. Additionally, a fever of 101 degrees Fahrenheit or higher should be reported. Though rare, loss of bowel or bladder control is a serious symptom that necessitates immediate medical care. Always follow the specific post-procedure instructions provided by your healthcare team and contact them with any concerns.