Table of ContentsView AllTable of ContentsUsesAdministrationBenefitsSide EffectsEffectivenessOther OptionsFrequently Asked Questions
Table of ContentsView All
View All
Table of Contents
Uses
Administration
Benefits
Side Effects
Effectiveness
Other Options
Frequently Asked Questions
If you havesciatica—nerve pain that causes discomfort in yourlower back, buttocks, and thigh—you may have tried many different treatments to find relief. For some individuals,epidural steroid injectionsmay be used to treat this condition.
This article explains what an epidural steroid shot is, the benefits, how it’s given, and its side effects. Information on other treatment options is also provided.
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Epidural Corticosteroid Injections for Sciatica
What Are Steroid Shots for Sciatica?
Epidural injections are one of the most common treatment options for managing lower back pain, includingsciatica, also known as lumbarradiculopathy.With these injections,cortisoneor another corticosteroid is placed into the tissue directly around where the pinched nerve meets the spine in an area known as the epidural space.
What Is the Epidural Space?
As an anti-inflammatory, the corticosteroid relieves inflammation around the nerve. This can reduce pain in the back and theradiating painrelated to sciatica, which might be felt in your legs or other areas.
Steroids, including corticosteroids, are very powerful. They should be used at the lowest strength possible while still being effective.
There are different types of corticosteroids that can be used to treat sciatica, and each has different guidelines for how much medication should be used. Your healthcare provider will determine which medication is best for you.
How Epidurals Are Administered
An epidural shot is usually given at a radiology facility. Before inserting the needle that will go into the epidural space, your healthcare provider will inject a local anesthetic into the skin at the location of the epidural. This will numb the area, so you don’t feel pain. However, you may still feel mild discomfort when the epidural is administered.
You will need to lie on your stomach for the procedure. Your provider may use fluoroscopy, an imaging tool, to guide them as they find the right location for the injection. Once it’s located, they will insert the needle and release the medication into the epidural space.
The entire process takes between 10 and 20 minutes. Afterward, you will be monitored for a short time. You should be able to sit up and walk almost immediately. You should not drive yourself home, however.
If the pain continues or returns, you can repeat the injections within two to four months.However, the shots cannot be repeatedly offered and are not advised for long-term use.
The benefits of epidural steroid injections vary significantly from person to person. Some people feel no change in their level of pain. Other people experience short-term relief. Still others enjoy long-lasting benefits and significantly less pain and discomfort for an extended period.
For some people with sciatica, epidural injections are not the end treatment. Instead, the injections are used in cooperation with surgical procedures to ensure the best long-term outcome.
Who Are Epidurals Good ForAn epidural corticosteroid injection is usually recommended only if medication, physical therapy, and pain management techniques have not been effective at relieving your pain.
Who Are Epidurals Good For
An epidural corticosteroid injection is usually recommended only if medication, physical therapy, and pain management techniques have not been effective at relieving your pain.
Epidural steroid injections are usually considered low-risk procedures that cause few side effects. However, there are some possible negative experiences that can result from receiving these shots:
While it’s not common, some people experience more pain, at least for a few days after the injection. In other rare instances, serious complications might occur. The most common of these is anallergic reaction.
Other possible problems include nerve damage, infection, and possible paralysis.
How Effective Are Steroid Shots for Sciatica?
Research on steroid shots for sciatica is limited.
One study looked at the effect of three different injections in the spine. About 80 individuals with sciatica either received steroid injections, anarthritis medication, orsalt water injections(a placebo, or sham treatment). Each person received two injections spaced two weeks apart.
Results gathered one month after the last injection found more improvement in symptoms with the epidural steroids than with the other treatments. However, the improvement was not significant when compared to the arthritis medication or salt water injection.
Another study noted that:
For some individuals, steroid injections can help with the pain associated with sciatica. Keep in mind that there may be a specific window of time when this treatment works best.
There are other options for sciatica relief either as an addition to steroid shots or as an alternative to them.
Your healthcare provider may also prescribe other medications,physical therapyexercises, or non-surgical therapy likespinal decompressionto attempt to treat your problem. In some cases, surgery may also be recommended.
Physical Therapy
Research indicates that exercise is one of the best and safest treatments for lumbar radiculopathy. A visit to yourphysical therapistcan help you find the right exercises for your needs.
Many people with back pain benefit from physical therapy programs like theMcKenzie Method, which specifically focuses on assessing and managing lower back pain.
While some individuals get relief from strengthening their core and hip muscles, others may require a combination of stretching and strengthening to help treat their back pain.
Exercises to try for back pain may include:
Proper treatment may help improve your spinal motion and decrease or eliminate your pain.
Be sure to check in with your healthcare provider before starting any treatment for your back pain or sciatica. Work with your healthcare provider and your physical therapist to find the right combination of treatment methods that work best for your needs.
Exercises for Your Lower Back
Non-Surgical Spinal Decompression
For non-surgical spinal decompression, your physical therapist uses equipment to gently stretch the spine. This is meant to take pressure off of compressed nerves that may be causing sciatica.
While some people have said they found relief from the procedure, there is limited research-based evidence that it’s an effective way to treat sciatica.
Surgery
Surgical decompression is usually only considered as a last resort if other methods of relieving pain have not worked.
During the procedure, your surgeon performs a laminectomy. This is when a portion of the vertebrae, known as thelamina—the bony walls of the vertebrae—are removed. This is usually done if there are bone spurs on the lamina that are placing pressure on the nerves in the spine.
Removing these bones may relieve the pressure, making your pain disappear.
Summary
Epidural steroid shots for sciatica may help some individuals experience symptom relief. This may be especially true for those with acute sciatica. However, research is limited.
Other treatments for sciatica include physical therapy and exercise. Be sure to check in with your healthcare provider and physical therapist before beginning a treatment program.
Non-surgical spine decompression is another treatment option with little evidence to show effectiveness. Still, you may want to discuss this procedure with your healthcare provider if you haven’t gotten relief from other non-invasive treatments. Surgery may be necessary for severe and debilitating cases of sciatica.
Learn MoreEpidural Space Anatomy and Injections
It can take 24 to 48 hours before you feel the benefits of the steroid injection for sciatica.
Shot benefits for sciatica tend to last for months.
10 SourcesVerywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.Ter meulen BC, Maas ET, Vyas A, et al.Treatment of acute sciatica with transforaminal epidural corticosteroids and local anesthetic: design of a randomized controlled trial.BMC Musculoskelet Disord. 2017;18(1):215. doi:10.1186/s12891-017-1571-8Harvard Health Publishing.Back pain: what you can expect from steroid injections.Manchikanti L, Knezevic NN, Boswell MV, Kaye AD, Hirsch JA.Epidural injections for lumbar radiculopathy and spinal stenosis: a comparative systematic review and meta-analysis.Pain Physician. 2016;19(3):E365-410.Hospital for Special Surgery.Epidural steroid injections: frequently asked questions.National Institute of Neurological Disorders and Stroke.Lower back pain fact sheet.Johns Hopkins.Epidural corticosteroid injections.Hospital for Special Surgery.Sciatica.Johns Hopkins Medicine.Sciatica.Cohen SP.Epidural steroids, etanercept, or saline in subacute sciatica: a multicenter, randomized trial.Ann Intern Med. 2012;156(8):551. doi:10.7326/0003-4819-156-8-201204170-00397Berry JA, Elia C, Saini HS, Miulli DE.A review of lumbar radiculopathy, diagnosis, and treatment.Cureus. 2019;11(10):e5934. doi:10.7759/cureus.5934
10 Sources
Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.Ter meulen BC, Maas ET, Vyas A, et al.Treatment of acute sciatica with transforaminal epidural corticosteroids and local anesthetic: design of a randomized controlled trial.BMC Musculoskelet Disord. 2017;18(1):215. doi:10.1186/s12891-017-1571-8Harvard Health Publishing.Back pain: what you can expect from steroid injections.Manchikanti L, Knezevic NN, Boswell MV, Kaye AD, Hirsch JA.Epidural injections for lumbar radiculopathy and spinal stenosis: a comparative systematic review and meta-analysis.Pain Physician. 2016;19(3):E365-410.Hospital for Special Surgery.Epidural steroid injections: frequently asked questions.National Institute of Neurological Disorders and Stroke.Lower back pain fact sheet.Johns Hopkins.Epidural corticosteroid injections.Hospital for Special Surgery.Sciatica.Johns Hopkins Medicine.Sciatica.Cohen SP.Epidural steroids, etanercept, or saline in subacute sciatica: a multicenter, randomized trial.Ann Intern Med. 2012;156(8):551. doi:10.7326/0003-4819-156-8-201204170-00397Berry JA, Elia C, Saini HS, Miulli DE.A review of lumbar radiculopathy, diagnosis, and treatment.Cureus. 2019;11(10):e5934. doi:10.7759/cureus.5934
Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.
Ter meulen BC, Maas ET, Vyas A, et al.Treatment of acute sciatica with transforaminal epidural corticosteroids and local anesthetic: design of a randomized controlled trial.BMC Musculoskelet Disord. 2017;18(1):215. doi:10.1186/s12891-017-1571-8Harvard Health Publishing.Back pain: what you can expect from steroid injections.Manchikanti L, Knezevic NN, Boswell MV, Kaye AD, Hirsch JA.Epidural injections for lumbar radiculopathy and spinal stenosis: a comparative systematic review and meta-analysis.Pain Physician. 2016;19(3):E365-410.Hospital for Special Surgery.Epidural steroid injections: frequently asked questions.National Institute of Neurological Disorders and Stroke.Lower back pain fact sheet.Johns Hopkins.Epidural corticosteroid injections.Hospital for Special Surgery.Sciatica.Johns Hopkins Medicine.Sciatica.Cohen SP.Epidural steroids, etanercept, or saline in subacute sciatica: a multicenter, randomized trial.Ann Intern Med. 2012;156(8):551. doi:10.7326/0003-4819-156-8-201204170-00397Berry JA, Elia C, Saini HS, Miulli DE.A review of lumbar radiculopathy, diagnosis, and treatment.Cureus. 2019;11(10):e5934. doi:10.7759/cureus.5934
Ter meulen BC, Maas ET, Vyas A, et al.Treatment of acute sciatica with transforaminal epidural corticosteroids and local anesthetic: design of a randomized controlled trial.BMC Musculoskelet Disord. 2017;18(1):215. doi:10.1186/s12891-017-1571-8
Harvard Health Publishing.Back pain: what you can expect from steroid injections.
Manchikanti L, Knezevic NN, Boswell MV, Kaye AD, Hirsch JA.Epidural injections for lumbar radiculopathy and spinal stenosis: a comparative systematic review and meta-analysis.Pain Physician. 2016;19(3):E365-410.
Hospital for Special Surgery.Epidural steroid injections: frequently asked questions.
National Institute of Neurological Disorders and Stroke.Lower back pain fact sheet.
Johns Hopkins.Epidural corticosteroid injections.
Hospital for Special Surgery.Sciatica.
Johns Hopkins Medicine.Sciatica.
Cohen SP.Epidural steroids, etanercept, or saline in subacute sciatica: a multicenter, randomized trial.Ann Intern Med. 2012;156(8):551. doi:10.7326/0003-4819-156-8-201204170-00397
Berry JA, Elia C, Saini HS, Miulli DE.A review of lumbar radiculopathy, diagnosis, and treatment.Cureus. 2019;11(10):e5934. doi:10.7759/cureus.5934
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