An epidural steroid injection (ESI) delivers anti-inflammatory medication, typically a corticosteroid, directly into the epidural space surrounding the spinal nerves. This fat-filled region encases the spinal cord and its nerves, and the injection targets inflammation and irritation to alleviate pain. Conditions like herniated discs, spinal stenosis, and sciatica often lead to such nerve inflammation, resulting in pain that can radiate to the arms, legs, or buttocks.
While an ESI aims to reduce this inflammation and provide pain relief, it does not correct the underlying structural problem. The injection often offers temporary relief, lasting days to several months, enabling individuals to engage in physical therapy and other rehabilitative efforts. Understanding post-injection care is important for optimizing recovery and ensuring safety.
Immediate Post-Injection Care
Prioritize rest and monitor your body’s response for the initial 24 to 48 hours after an ESI. Rest for at least two hours immediately after the procedure, often in a reclined position to minimize back pressure. Avoid driving for at least 24 hours due to potential temporary numbness, weakness, or dizziness from the anesthetic or sedation. If sedated, have a responsible person drive you home.
During this initial period, refrain from strenuous activities, heavy lifting, or high-impact exercises. Limit walking or sitting to short intervals (10-20 minutes) to prevent strain on the injection site. You can resume your normal diet and prescribed medications unless instructed otherwise by your doctor. The bandage can usually be removed after 24 hours; showering is permitted once it’s off.
Understanding and Managing Post-Injection Sensations
After an ESI, expect various sensations as the local anesthetic wears off and the steroid takes effect. Temporary numbness or weakness around the injection site, or down an arm or leg, typically resolves within hours. Soreness or mild pain at the injection site may last a couple of days. Applying an ice pack for 15-20 minutes can help reduce discomfort and swelling.
A temporary increase in pain in the treated area is possible before the steroid provides relief. This can occur because fluid introduction into the epidural space, where nerves may be inflamed, can momentarily increase pressure. Full pain relief may not be noticeable for 2-7 days, with peak relief often around two weeks after the injection. Over-the-counter pain relievers, like acetaminophen, can manage these sensations; consult your healthcare provider about appropriate medications.
Gradual Return to Activity
After the initial rest, gradually return to activities to support recovery and maximize the injection’s benefits. Avoid immediate strenuous activity, but incorporate light movement like short walks and gentle stretching to maintain mobility and promote circulation. Continue avoiding heavy lifting (over 10-20 pounds) and vigorous, high-impact exercises for at least one to two weeks post-injection. This prevents undue stress on the treated area and allows the medication to work effectively.
Physical therapy often plays a significant role in long-term recovery, often beginning about one week after the injection. A physical therapist can guide exercises to strengthen spinal muscles, improve flexibility, and address pain-contributing imbalances. The injection provides a window of reduced pain, useful for rehabilitation progress. Listen to your body and incrementally increase activity, avoiding discomfort-causing movements.
When to Contact Your Doctor
While ESIs are generally safe, certain symptoms warrant prompt medical attention to rule out complications. Contact your doctor immediately if you experience a fever, especially 100.5°F (38.5°C) or higher. Signs of infection at the injection site, including increased redness, warmth, swelling, or discharge, require urgent evaluation.
Seek medical advice if you develop severe headaches that worsen when sitting or standing but improve when lying down, as this could indicate a dural puncture. New or worsening numbness or weakness in your arms or legs, or any new loss of bladder or bowel control, necessitate immediate medical consultation. Persistent, severe pain that does not improve after 48 hours or changes location should also be reported.