What are the side effects of cortisone injections in the lower back

Q: How long does a cortisone shot last in the lower back?

These injections dont always work. When they do, it takes 1 to 5 days. This pain relief can last for several days to a few months or longer.

A lumber epidural steroid injection is a treatment to relieve pain in your lower back or legs caused by inflammation of the nerves in your spine.

Índice Show

How steroid injections are given
Side effects of steroid injections
Who can have steroid injections
How steroid injections work
What can you not do after a cortisone shot in the back?
How safe are cortisone shots in the back?
How long does it take to recover from a cortisone shot in the back?
How long does a cortisone shot last in the lower back?

Steroids, also called corticosteroids, are medications that bring down inflammation. Your doctor gives the injection into the epidural space around the spinal cord in your lower back.

You might get a lumbar steroid injection if you have pain from:

a herniated disc
spinal stenosis
degenerative spine disease
bone spurs

Everyone responds to the procedure differently. In general, a lumbar epidural steroid injection can be a bit uncomfortable, but it shouldn’t be painful. You can ask your doctor for a mild sedative to relax you before the procedure.

Your doctor will first inject a local anesthetic into the skin on your back to numb the area. The injection might cause a mild burning or stinging sensation.

You’ll likely feel some pressure when your doctor inserts the needle into the epidural space to inject the steroid medication. If you do feel any pain, your doctor can give you more of the local anesthesia to relieve it.

The epidural injection should start to relieve your back pain within 1 to 3 days. But sometimes it can take up to a week to see an improvement.

This treatment isn’t a cure for back pain, although some people do get permanent relief. Typically, if you’ve had chronic back pain, the injection may continue to work for 3 to 6 months or longer.

If the pain returns, you may need to get injections a few times a year. To potentially help extend the effects of this treatment, you may want to consider:

exercising regularly
not smoking
staying at a healthy weight for your body

Recovery from an epidural steroid injection is usually quick.

You won’t be able to drive for the rest of the day and will need someone to help you get home from the appointment.

Avoid soaking in a tub, pool, shower, or any other water until your doctor says you can resume these activities.

You should be able to go back to your usual activities the day after the procedure. But soreness might keep you from more strenuous activities, such as exercise, for a few days.

Your back might be a little sore for a few days after the injection. Holding an ice pack to the area three or four times per day and taking an over-the-counter pain reliever can help.

Epidural steroid injections are safe overall. The most common side effects are mild and may include:

pain at the injection site
redness of your face and chest, called a steroid flush
trouble sleeping
anxiety
hot flashes
an increase in blood sugar levels
fluid buildup
increased back pain
headache

These side effects should improve without treatment within 1 or 2 days.

More serious problems are rare but can include:

bleeding
allergic reaction
infection
nerve damage
numbness or tingling
paralysis

Let your doctor know if your back still hurts a few days after the injection. And call your doctor’s office right away if you have more serious side effects, such as bleeding or an allergic reaction. Call 911 or go to an emergency room if you need emergency care.

Before receiving an epidural steroid injection, discuss the benefits and risks of this treatment with your doctor.

Epidural steroid injections temporarily — and sometimes permanently — relieve back and leg pain from conditions such as a herniated disc or degenerative spine disease. Results can last for several months.

If you get a steroid injection and your pain doesn’t improve, talk with your doctor. The pain may not be coming from nerves in your spine.

You may need more tests to figure out the cause and a different type of treatment to relieve it.

Steroid injections, also called corticosteroid injections, are anti-inflammatory medicines used to treat a range of conditions.

They can be used to treat problems such as joint pain, arthritis, sciatica and inflammatory bowel disease.

Steroid injections are only given by healthcare professionals. Common examples include hydrocortisone, triamcinolone and methylprednisolone.

How steroid injections are given

Steroid injections are usually given by a specialist doctor in hospital.

They can be given in several different ways, including:

into a joint (an intra-articular injection)
into a muscle (an intramuscular injection)
into the spine (an epidural injection)
into the blood (an intravenous injection)

The injections normally take a few days to start working, although some work in a few hours. The effect usually wears off after a few months.

If you're having an injection to relieve pain, it may also contain local anaesthetic. This provides immediate pain relief that lasts a few hours.

You should be able to go home soon after the injection. You may need to rest the treated body part for a few days.

Side effects of steroid injections

Possible side effects of steroid injections depend on where the injection is given.

Side effects of injections into the joints, muscles or spine can include:

pain and discomfort for a few days – paracetamol may help with this
temporary bruising or a collection of blood under the skin
flushing of the face for a few hours
an infection, causing redness, swelling and pain – get medical advice as soon as possible if you have these symptoms
a loss of fat where the injection was given – this can cause dimples in the skin and may be permanent
paler skin around the site of the injection – this may be permanent
if you have diabetes, your blood sugar level may go up for a few days
if you have high blood pressure, your blood pressure may go up for a few days

Epidural injections can also occasionally give you a very painful headache that's only relieved by lying down. This should get better on its own, but tell your specialist if you get it.

Side effects of injections given into the blood tend to be similar to side effects of steroid tablets, such as increased appetite, mood changes and difficulty sleeping.

You can report any suspected side effect to a UK safety scheme.

Who can have steroid injections

Most people can have steroid injections.

Tell the doctor before having treatment if you:

have had a steroid injection in the last few weeks – you usually need to wait at least 6 weeks between injections
you've had 3 steroid injections in the last year – doctors usually recommend no more than 3 injections in the same area in the space of 12 months
have had an allergic reaction to steroids in the past
have an infection (including eye infections)
have recently had, or are about to have, any vaccinations
are pregnant, breastfeeding or trying for a baby
have any other conditions, such as diabetes, epilepsy, high blood pressure, or problems with your liver, heart or kidneys
are taking other medicines, such as anticoagulants

Steroid injections may not always be suitable in these cases, although the doctor may recommend them if they think the benefits outweigh any risks.

How steroid injections work

Steroids are a manmade version of hormones normally produced by the adrenal glands, 2 small glands found above the kidneys.

When injected into a joint or muscle, steroids reduce redness and swelling (inflammation) in the nearby area. This can help relieve pain and stiffness.

When injected into the blood, they can reduce inflammation throughout the body, as well as reduce the activity of the immune system, the body's natural defence against illness and infection.

This can help treat autoimmune conditions, such as multiple sclerosis (MS), which are caused by the immune system mistakenly attacking the body.

Steroid injections are different from the anabolic steroids used illegally by some people to increase their muscle mass.

Page last reviewed: 26 February 2020
Next review due: 26 February 2023

What can you not do after a cortisone shot in the back?

Lumbar Epidural Steroid Injection.

You may resume normal activity as your comfort level allows, but do not engage in any strenuous activity for the first 24 hours after the procedure..

You can return to work 24 hours after your procedure..

You may eat whatever you wish and resume all prior medications..

How safe are cortisone shots in the back?

Lumbar epidural steroid injections are usually safe, but there are risks of certain side effects and complications. Although rare, risks and complications that apply to lumbar ESI injections include: Low blood pressure, which can make you feel lightheaded. Severe headache caused by spinal fluid leakage.

How long does it take to recover from a cortisone shot in the back?

Cortisone shots commonly cause a temporary flare in pain and inflammation for up to 48 hours after the injection. After that, your pain and inflammation of the affected joint should decrease, and can last up to several months.