Next step after epidural steroid injection

You have received an injection of local anesthetic and corticosteroids. The local anesthetic effect typically last 4–6 hours. It may take 3–7 days for the corticosteroids to reach optimal effect.
Please pay close attention to the following information/instructions:

  1. You may not drive for 12 hours after your injection.
  2. It is common to experience mild soreness at the injection site(s) for 24–48 hours. Ice is the best remedy. You may apply ice for 20 minutes at a time several times a day as needed.
  3. Avoid heat to the injection area for 72 hours. No hot packs, saunas, or steam rooms during this time. A regular shower is OK.
  4. You may immediately restart your regular medication regimen, including pain medications, anti-inflammatory, and blood thinners.
  5. Please remove the sterile dressing/band-aid tonight or tomorrow morning. Do not leave it on after you have taken a shower or gotten it wet.
  6. Corticosteroid side effects can occur after this injection, but they usually resolve after several days. These side effects can include flushing, hot flashes, mild palpitations, insomnia, water retention, feeling anxious/restless, or headaches.
  7. While it is extremely rare to get an infection after a spinal procedure, please call the office if you develop any signs of infection. These signs include fevers/chills, severely increased pain, redness at the injections site, or any drainage from the injection site.
  8. Remember that the corticosteroid benefit (long-term pain relief) from an injection can take as long as 10 days to occur. You may have a period of slightly increased pain after your injection before the cortisone takes effect.
  9. You may resume all of your normal daily activities 24 hours after your injection.
  10. It is OK to restart your exercise or physical therapy program as soon as you feel comfortable doing so.
  11. Please complete the pain diary given to you after your injection. The information you provide on this diary is used to guide your treatment plan.
  12. You should schedule a follow-up visit in 2–3 weeks to review your response to this injection.
  13. Please bring your pain diary with you to this appointment.

What is the next step if an epidural injection doesn't work?

An alternative to ESIs, or an option to consider if injections are no longer providing relief, is the mild® Procedure. mild® stands for minimally invasive lumbar decompression. It's a short outpatient procedure that relieves pressure on the spine through an incision smaller than the size of a baby aspirin (5.1 mm).

How do I know if my epidural steroid injection is working?

Most people do not feel any different immediately after the injection, although the pain may be temporarily improved or worsened. The steroid takes two to three days to start to have an effect in most people, and it peaks in about two weeks. Therefore, it may be a while before you feel a change in your pain.

What happens if epidural steroid injection doesn't work?

3 Things To Do When Epidural Steroid Injections Don't Work Consider physical therapy. You might need to enroll in physical therapy to strengthen some of the muscles and ligaments around your back. With extra support, your pain could start to wear off. Talk to your doctor about surgery.

What is the success rate of epidural steroid injections?

In another study conducted for the Humana Press, only 38% of those treated found any relief whatsoever after administering cervical epidural steroid injections for their pain.