Epidural Steroid Injections for Sciatica: What to Expect

What Is Sciatica?

Sciatica refers to pain that travels from your lower back into your buttock, leg, and sometimes into the foot due to irritation or compression of the sciatic nerve or its nerve roots. Patients often describe sharp, shooting, burning, or electric pain, sometimes with numbness, tingling, or weakness in the leg.

Common causes of sciatica include:

• Herniated or bulging lumbar discs pressing on a nerve root
• Lumbar spinal stenosis (narrowing of the spinal canal)
• Degenerative disc disease
• Spondylolisthesis (one vertebra slipping over another)

When these conditions inflame or compress the nerve root, the brain perceives pain along the nerve’s path down the leg.

How Epidural Steroid Injections Help Sciatica

Epidural steroid injections deliver a powerful anti-inflammatory medication (a corticosteroid) directly into the epidural space around the irritated spinal nerves. By reducing inflammation and swelling around the nerve root, the injection can decrease pain, improve mobility, and allow you to better participate in stretching, exercise, and physical therapy.

Key points for patients with sciatica:

• The injection treats inflammation and pain, not the underlying structural problem itself.
• It is a targeted treatment focused on the specific nerve root causing your leg pain.
• For many people, it can provide enough relief to avoid or delay surgery while other conservative treatments continue.

Epidural steroid injections are often recommended when:

• Sciatica has lasted more than a few weeks despite rest, NSAIDs, or physical therapy.
• Pain is severe enough to interfere with sleep, work, or daily activities.
• MRI or other imaging shows disc herniation, stenosis, or other findings that match your symptoms.

Conditions Treated with Epidural Steroid Injections

Epidural steroid injections are used to treat sciatica and other forms of nerve-related spinal pain when conservative care has not provided adequate relief. Conditions include:

• Herniated discs
• Lumbar radiculopathy (irritation of a nerve root)
• Sciatica
• Spinal stenosis

For patients whose main problem is leg pain from sciatica rather than isolated low back pain, epidural steroid injections can be particularly effective.

How the Procedure Is Performed

At CORE Medical & Wellness, epidural steroid injections are performed by a double board-certified pain medicine specialist using precise X-ray guidance. This allows the medication to be delivered exactly where it is needed around the irritated nerve.

Step by step, you can expect:

1. Positioning

You will lie face down on a procedure table, and the skin over your lower back will be cleaned with an antiseptic solution.

2. Local Anesthetic

A small amount of local anesthetic is injected to numb the skin and deeper tissues. Some patients describe a brief sting or burn that quickly fades.

3. X-Ray Guidance (Fluoroscopy)

Using a live X-ray called fluoroscopy, the physician carefully guides a thin, specialized needle into the epidural space near the affected nerve root.

4. Contrast Dye

A small amount of contrast dye is injected to confirm that the needle tip is in the correct location and that the medication will spread properly in the epidural space.

5. Steroid and Anesthetic Injection

A mixture of corticosteroid (to reduce inflammation) and local anesthetic (for temporary numbing) is then slowly injected. You may feel some pressure, but most patients tolerate this step well.

The actual injection typically takes only a few minutes, though you should plan to be at the office longer for check-in and brief post-procedure monitoring.

Will the Injection Hurt?

Most patients find that epidural steroid injections are easier than they expected. The main discomfort is usually the brief sting of the local anesthetic and a feeling of pressure as the medication is injected.

Important points:

• IV sedation is available if you are very anxious, but most patients do well with local anesthetic alone.
• If you choose IV sedation, you must fast (no food or drink) for eight hours before the procedure, and you will need a responsible adult to drive you home.
• If you take medications for high blood pressure or heart disease, you can usually take them with a small sip of water on the morning of your procedure unless instructed otherwise.

Some patients may experience temporary muscle spasms during or right after the injection, but this is uncommon and typically short-lived.

When Will I Feel Relief?

Pain relief from an epidural steroid injection does not happen instantly for most patients.

Typical timeline:

• First few hours: The local anesthetic may provide temporary numbness or reduction in pain.
• After 1 to 2 hours: As the anesthetic wears off, your usual pain may return temporarily.
• Next 24 hours: Many patients start noticing improvement by the next day.
• 3 to 5 days: Maximum benefit is often reached within three to five days after the injection.

Some patients with sciatica experience dramatic relief, while others notice a more gradual reduction in pain and improved function.

Possible Side Effects and Risks

Epidural steroid injections are generally very well tolerated, and serious complications are rare, especially when performed by an experienced physician using imaging guidance. However, like any medical procedure, there are potential side effects and risks.

Common, Usually Mild Side Effects

• “Steroid flush”: facial redness, warmth, sweating, and a low-grade fever
• Mild nausea
• Itching or a small rash
• Temporary increase in pain at the injection site or in the back and leg

These effects typically resolve within a few days without specific treatment.

More Serious but Rare Complications

• Infection at the injection site or in the epidural space
• Significant bleeding or hematoma
• Severe allergic reaction
• Nerve damage

Call our office right away or go to the nearest emergency room if you experience:

• High fever or chills
• Increasing redness, swelling, or warmth at the injection site
• Severe or worsening back or leg pain
• New weakness, numbness, or difficulty controlling your bladder or bowels

How Long Does Relief Last? Can Injections Be Repeated?

The duration of pain relief varies from patient to patient and depends on the underlying condition, severity of nerve inflammation, and your overall health.

Typical patterns:

• Many patients experience significant relief that lasts 3 to 6 months.
• Some patients need a follow-up injection sooner if sciatica symptoms gradually return.
• Others may have more modest relief but still benefit enough to resume therapy and activity.

The goal is to use injections as part of a broader, comprehensive strategy that may also include physical therapy, home exercise, weight management, and other treatments tailored to your needs.

Are Epidural Steroid Injections Right for My Sciatica?

You may be a good candidate for an epidural steroid injection if:

• You have leg pain, numbness, or tingling that follows a sciatic nerve pattern.
• Symptoms have not improved adequately with medications, rest, and physical therapy.
• Imaging shows a condition such as a herniated disc or spinal stenosis that matches your symptoms.
• You are trying to avoid or delay surgery, or you are not a surgical candidate.

During your visit, the pain specialist will evaluate your medical history, perform a physical exam, review your imaging, and discuss your goals to determine if an epidural steroid injection is appropriate.

Why Choose CORE Medical & Wellness for Sciatica Treatment?

At CORE Medical & Wellness, epidural steroid injections are part of a fully integrated approach to spine and nerve pain. Dr. Richard Kang is double board certified in anesthesiology and pain medicine and completed an interventional pain medicine fellowship at New York Presbyterian Hospital / Columbia University – College of Physicians and Surgeons.

Our team focuses on:

• Accurate diagnosis of the cause of your sciatica
• Targeted, image-guided procedures to maximize relief and safety
• Combining injections with rehabilitation, exercise, and other modalities to improve long-term outcomes

We provide care at multiple convenient locations in New Jersey, including Lyndhurst, Kenilworth, Aberdeen, Wyckoff, and Closter.

Schedule a Sciatica Consultation

If sciatica is limiting your ability to work, exercise, or enjoy daily life, you do not have to keep suffering. To learn whether an epidural steroid injection is appropriate for your sciatica and to explore all of your treatment options, contact CORE Medical & Wellness today at 201-729-0001 or request an appointment through our online form.

During your visit, we will take time to answer your questions, review your imaging, and design a personalized plan to help you get back to the activities you love with less pain.