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Do epidural injections work? Who they help most, how to tell if yours worked, and what comes next
Do epidural injections work? For many people they do, but mainly for one kind of pain: pain that travels down an arm or leg from an irritated spinal nerve, as with a herniated disc, sciatica or spinal stenosis. In that group, many patients get meaningful relief that lasts weeks to months, which gives the nerve time to settle and makes physical therapy possible. Results are less reliable for back pain that stays in the back, and an epidural does not repair the disc itself. Whether one will work for you depends mostly on having the right diagnosis first.
Few treatments get as many mixed reviews as the epidural steroid injection. Some people say it gave them their life back; others felt little change. Both can be true, because how well it works depends on why you hurt. This post answers the question honestly. If you want to know what the injection is and how it is done, see epidural steroid injection for back pain, and for the days after, our epidural steroid injection recovery guide.
Do epidural injections work for everyone?
No. They work best when the pain comes from inflammation around a spinal nerve root:
- Most likely to help: sciatica or arm pain from a herniated or bulging disc, especially in the first months; leg pain with walking from spinal stenosis
- Sometimes helps: long-standing nerve pain, or mixed back and leg pain
- Less likely to help: back pain that stays in the back without leg symptoms, which more often comes from the facet joints, discs or muscles and may respond better to medial branch blocks and radiofrequency ablation or therapy
The videos show why: the medicine is guided to the irritated nerve, so it helps most when that nerve is the source.
How to tell if your epidural worked
The steroid usually takes two to seven days to start working, and some people notice it closer to two weeks. Keep a simple daily pain score from 0 to 10 before and after, and notice what you can do: walk farther, sit longer, sleep through the night. Relief of half or more of your leg pain is generally considered a good response. The numbing medicine can bring brief relief on the first day, then wear off before the steroid starts; that is expected and not a sign it failed.
How long the relief lasts
It varies from a few weeks to several months, and for some people with a recent disc herniation the pain does not return because the nerve has had time to heal. If a first injection helps and the pain comes back, it can be repeated, but most physicians limit epidurals to a few a year because of the steroid. The best long-term results come when the relief window is used for physical therapy to build strength and better movement habits.
Why an epidural sometimes does not work
- The pain is not coming from a nerve root, for example facet joint or sacroiliac joint pain
- The injection reached a different level or side than the irritated nerve; image guidance with fluoroscopy makes accurate placement much more likely
- Severe or long-standing nerve compression that needs a surgical opinion
- Pain driven by many factors, such as deconditioning, sleep and stress, that needs a broader plan
If the epidural does not help
A disappointing result is still useful information. Your physician may re-check the diagnosis with an exam, imaging or an EMG/NCV test, try a different approach such as a transforaminal epidural aimed at one nerve, treat another source of pain, or step up rehab. For nerve pain that persists after other treatments, a spinal cord stimulator trial may be an option, and each of our physicians offers it. A surgeon’s opinion makes sense for progressive weakness or pain that keeps you from working. Our back pain injections post compares the main injection types.
More videos on how epidural injections work
More clips from our YouTube channel @precisioncaremedical showing guided epidural injections and how the medicine reaches the nerve.
Related care at Precision Care Medical & Sports Performance
An epidural injection near you
Looking for an epidural injection near me? Epidural injections are offered by our pain physicians, Ashley Marcus, MD in Brooklyn, Jake Stephen, DO on Staten Island and Yuri Gordin, MD in Manhattan. Pain procedures are performed at all three offices, and your physician explains where and when yours will be scheduled.
Our Brooklyn pain management office on Shell Rd is close to Midwood, Marine Park and Sheepshead Bay, for an epidural injection in Brooklyn. On Staten Island, our Staten Island pain management office on Richmond Rd is a short drive from Dongan Hills, Grant City and New Dorp. For an epidural injection in Midtown East, the Precision Care Spine & Pain Center in Midtown Manhattan is on E 55th St, an easy trip from the Financial District, Washington Heights and Spanish Harlem. Request an appointment or call the office closest to you.
150 E 55th St, Suite 401, New York, NY 10022
(212) 840-0135
Questions patients ask
Do epidural injections work for sciatica?
They often help sciatica from a herniated disc or stenosis, because the medicine is placed around the irritated nerve. Many patients get relief that lasts weeks to months, which makes physical therapy easier.
What is the success rate of an epidural injection?
It depends on the diagnosis. Results are best for leg or arm pain from an irritated nerve and less reliable for back pain alone. Relief of half or more of the leg pain is usually counted as a good response.
How long does it take for an epidural to work?
The steroid usually starts working within two to seven days, sometimes up to two weeks. Brief numbness or relief on the first day comes from the local anesthetic and can wear off before the steroid starts.
What if my epidural injection did not work?
Your physician may re-check the diagnosis, try a different injection approach or level, treat another source of pain such as the facet joints, step up rehab, or, for persistent nerve pain, discuss a spinal cord stimulator trial or a surgical opinion.
How many epidural injections can you have?
If the first one helps, it can be repeated when pain returns, but most physicians limit epidural steroid injections to a few a year. Your physician will set the plan based on your response and health.
Where can I get an epidural injection near me?
Precision Care Medical & Sports Performance offers epidural injections at all three offices:
- Brooklyn2781 Shell Rd, Suite 101, Brooklyn, NY 11223(718) 648-1234 · Get directions
- Staten Island1630 Richmond Rd, Suite 101, Staten Island, NY 10304(718) 339-7100 · Get directions
- Midtown Manhattan150 E 55th St, Suite 401, New York, NY 10022(212) 840-0135 · Get directions
Your physician explains where and when yours will be scheduled.
Educational only, not medical advice. These videos and this article explain common problems and treatments in general terms. They are not a diagnosis or a treatment plan for you. Results vary from person to person. See a qualified clinician about your own symptoms, and call 911 or go to an emergency room for an emergency.
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