Epidural Injections: What It Is and What to Expect
Medically reviewed by Sumiran Racherla, MD, Internal Medicine. Last reviewed: October 23, 2026.
What kind of doctor provides Epidural Injections?
A pain medicine doctor (a doctor who treats long-lasting pain) or a spine doctor often gives epidural injections. The injection is done in a hospital or an outpatient clinic. A direct primary care or concierge doctor can be a first stop for an evaluation and can refer you to a specialist when needed.
What it is
Here, epidural injections means steroid shots for back pain. An epidural injection for back pain delivers a strong anti-inflammatory medicine into the epidural space. The medicine is a mix of steroid and numbing medicine. It lowers swelling and pressure on the larger nerves around your spine and helps relieve pain. It is not the same as the epidural anesthesia given before childbirth or certain types of surgery.
Why a doctor might recommend it
A provider may suggest an epidural injection for pain that spreads from the lower spine to the hips or down the leg. This pain is caused by pressure on a nerve as it leaves the spine, most often due to a bulging disk. The shot is used only when medicines, physical therapy, or other nonsurgical treatments have not eased your pain.
How to prepare
Your provider will most likely order an x-ray, MRI, or CT scan of your back first.
- Tell your provider if you are or could be pregnant.
- Tell your provider about all medicines, supplements, and herbs you take, even ones bought without a prescription.
- You may be asked to stop blood thinners for a short time.
- Ask which medicines you should still take on the day of the procedure.
- Follow the instructions about when to stop eating and drinking.
What happens during it
You change into a gown and lie face down on an x-ray table. Your provider cleans your back, and medicine may be used to numb the area. Your provider puts a needle into your back, likely with an x-ray machine that shows real-time images.
Contrast dye is used first to confirm that the medicine is going to the right place. There are three common ways to deliver steroid into the epidural space.
- An interlaminar injection puts the needle in through the back of the epidural space.
- A caudal injection uses a small bony opening just above the tailbone.
- A transforaminal injection places the needle alongside the nerve as it leaves the spine.
You may feel some pressure, but most of the time the procedure is not painful.
Recovery
You are watched for 15 to 20 minutes after the injection before going home. Your pain may get worse for 2 to 3 days before it starts to improve. The steroid usually takes 3 to 5 days to work.
The shot does not cure the cause of your back pain, so you will need to keep up back exercises and other treatments.
Risks and side effects
An epidural injection is generally safe, but problems can happen. Serious problems are rare.
- Dizziness, headache, or feeling sick to your stomach, which are usually mild.
- Nerve root damage with more pain down your leg.
- Infection in or around your spine, such as meningitis or an abscess.
- Allergic reaction to the medicine.
- Bleeding around the spinal column, called a hematoma.
- Trouble breathing if the injection is in your neck.
Having these shots too often may weaken the bones of your spine or nearby muscles. Most providers limit people to two or three injections per year.
Call 911 or go to the emergency room if you have trouble breathing, fainting, or bleeding that will not stop. Also call if you have chest pain or discomfort lasting two minutes or more, sudden weakness, or a change in mental status such as confusion.
Who performs it
A health care provider does the injection, using an x-ray machine to guide the needle. When an experienced doctor uses x-ray guidance, the risk of a serious problem is minimized.
Common questions
Is an epidural injection the same as an epidural for childbirth?
No. An epidural injection for back pain is not the same as the epidural given before childbirth or some surgeries.
How long does an epidural injection take to work?
The steroid usually takes 3 to 5 days to work. Your pain may get worse for 2 to 3 days first.
How does a direct primary care or concierge doctor fit in?
A direct primary care doctor charges a flat monthly fee instead of billing insurance, while a concierge doctor usually charges more and often works alongside insurance. A direct primary care or concierge doctor can be a first stop for an evaluation and can refer you to a specialist when needed.
Sources
- MedlinePlus - Epidural injections for back pain
- North American Spine Society - Epidural Steroid Injections
Medical Disclaimer
This content is for general educational and informational purposes only and is not medical advice. It is not a substitute for professional medical advice, diagnosis, or treatment, and reading it does not create a doctor-patient relationship. Always seek the advice of your physician or another qualified health provider with any questions about a medical condition, and never disregard or delay seeking professional advice because of something you read here. If you think you may have a medical emergency, call 911 (or your local emergency number) immediately.
