Last Updated on November 26, 2025 by Bilal Hasdemir

Many people turn to epidural corticosteroid injections for chronic back pain. But, about 40% of them don’t see much pain relief afterward.Understand why there’s no pain relief after epidural steroid injection and how long recovery takes.

At Liv Hospital, we get how tricky lumbar epidural steroid injections can be. Our team is here to help you understand why you might not feel better right away. We’ll guide you through what to do next.

Key Takeaways

• Epidural corticosteroid injections are a common treatment for chronic back pain.
• Up to 40% of patients may not experience significant pain relief after the procedure.
• Liv Hospital provides a detailed look at why some patients don’t feel better.
• Our team is committed to helping you through this process.
• Knowing what to do next is key to managing your pain effectively.

Understanding Epidural Corticosteroid Injections

Epidural corticosteroid injections are a common treatment for spine pain. They involve putting a corticosteroid medication into the space around the spinal cord.

What Are Epidural Steroid Injections?

Epidural steroid injections put corticosteroids into the space around the spinal cord. This area has fat, blood vessels, and nerves. The goal is to reduce swelling and pain around the nerves.

The procedure is done under imaging like fluoroscopy. This ensures the medication is placed correctly. This accuracy helps the treatment work better and reduces side effects.

How Corticosteroids Work to Reduce Pain and Inflammation

Corticosteroids are strong anti-inflammatory agents. They mimic the body’s cortisol hormone. When injected, they reduce inflammation and pain in the spine.

“Corticosteroids are effective in reducing inflammation and relieving pain in various spinal conditions, making them a valuable treatment option for patients with chronic back and neck pain.”

Common Spine Conditions Treated with Epidural Injections

Epidural corticosteroid injections treat many spinal conditions. These include:

• Herniated discs
• Spinal stenosis
• Degenerative disc disease
• Spondylolisthesis
• Radiculopathy

Understanding epidural corticosteroid injections helps patients make informed choices. It’s important to talk to a healthcare professional. They can decide if these injections are right for you.

The Success Rate of Spinal Steroid Injections

Knowing how well spinal steroid injections work is key for those thinking about them. These injections are a common way to handle back and neck pain. But, how well they work can really differ from person to person.

Statistical Overview of Effectiveness

Research shows that these injections can really help a lot of people with pain. But, how well they work depends on a few things. These include the type of pain, how well the injection is done, and the person’s health.

Studies say that epidural steroid injections work for 50% to 90% of people. Some even say up to two-thirds see a big improvement. But, what counts as “success” can change these numbers.

Factors That Influence Positive Outcomes

Several things can make spinal steroid injections more likely to work. These include:

• The specific spinal condition being treated
• The accuracy of the injection placement
• Patient-specific factors such as overall health and the presence of other medical conditions
• The type and dosage of corticosteroid used

Accurate diagnosis and precise injection technique are key for the best results.

Realistic Expectations for Back and Neck Pain Relief

It’s important for patients to know what to expect from spinal steroid injections. While they can help a lot of people, they don’t work for everyone.

These injections aim to help people feel well enough to start physical therapy. They’re not meant to get rid of all pain.

By knowing what to expect, patients can make better choices about their treatment.

Why There Is No Pain Relief After Epidural Steroid Injection

For some, epidural steroid injections don’t work as hoped. This leads to looking into why. Several reasons can explain this, and knowing them is key to finding the right treatment.

Misdiagnosis of the Pain Source

One big reason is when the pain’s cause is not correctly found. If the real problem is not pinpointed, the injection might not hit the mark. Getting the diagnosis right is essential for success with these injections.

Structural Issues That Limit Effectiveness

Spinal problems can also make these injections less effective. Issues like severe spinal stenosis or big disc herniations might not get better with steroids. In these cases, other treatments or more serious procedures might be needed to fix the spine.

Injection Placement Accuracy Concerns

How well the injection is placed is also very important. If the steroid doesn’t go to the right spot, it won’t work. Using imaging during the shot can help place it more accurately.

Individual Patient Factors Affecting Response

Each person’s health and other factors can also play a part. For example, people with diabetes or on certain meds might react differently. Knowing these details helps doctors tailor treatments better.

Looking into these reasons helps doctors and patients find the best treatment plan together.

The Timeline: How Long For Epidural Steroid Injection To Work

Many patients wonder when they’ll feel relief from epidural steroid injections. The time it takes for these injections to work can differ a lot. Knowing this timeline helps manage expectations and make treatment choices.

Immediate Effects (1-3 Days Post-Injection)

Some patients feel better right away or see pain drop within a few days. This is often because of the local anesthetic mixed with the steroid. But, this quick relief is usually short and mainly from the anesthetic, not the steroid.

Short-Term Results (1-2 Weeks)

The steroid part of the injection starts working in 1-2 weeks. During this time, patients might notice pain and swelling going down. This is because steroids reduce inflammation, which takes time.

Long-Term Outcomes (Beyond 2 Weeks)

For many, the best effects of epidural steroid injections show up after two weeks. The steroid’s anti-inflammatory effects can keep providing relief for weeks or months. How long this relief lasts varies, depending on the condition and how well the injection was done.

When to Expect Maximum Benefit

Most people see the best results from epidural steroid injections in 2-3 weeks. But, this can vary. Some might feel relief for months, while others might not last as long. What affects how long relief lasts includes the condition, individual factors, and the injection technique.

It’s important for patients to check in with their healthcare provider to see how well the treatment is working. By understanding when epidural steroid injections start working, patients can better plan their treatment and make informed choices.

Types of Epidural Steroid Injections and Their Efficacy

It’s important to know the different types of epidural steroid injections. They are used to treat various spinal conditions. The success of these injections depends on the type and the condition being treated.

Lumbar Epidural Steroid Injections for Lower Back Pain

Lumbar epidural steroid injections help with lower back pain. This includes pain from herniated discs, spinal stenosis, and degenerative disc disease. The injections put corticosteroids into the epidural space around the lumbar spine. This reduces inflammation and relieves pain.

Many people find these injections very helpful. But, how well they work can depend on the severity of the condition and how accurately the injection is placed.

Cervical Epidural Injections and Neck Pain Relief

Cervical epidural injections treat neck pain. This includes pain from cervical disc herniation and spinal stenosis. The injections put corticosteroids into the cervical epidural space. This helps reduce inflammation and eases neck and arm pain.

These injections can be very effective. But, they need to be placed very carefully because of the sensitive cervical spine. The success of these injections can also depend on the severity of the condition and the patient’s health.

Thoracic Epidural Steroid Injections

Thoracic epidural steroid injections are less common. They are used to treat pain in the thoracic region. This includes pain from thoracic disc herniation or spinal stenosis. The injections put corticosteroids into the thoracic epidural space.

The success of these injections can vary. They are often considered when other treatments have not worked. The procedure requires careful consideration due to the complex anatomy of the thoracic spine.

Caudal Epidural Approaches

Caudal epidural injections involve injecting corticosteroids into the caudal space. This is part of the epidural space accessed through the sacral hiatus. This approach is often used for chronic pain in the lower back and legs.

Caudal epidural injections can be very helpful for some patients. They are useful for those who have not responded to other injections or have certain anatomical conditions. The success of these injections can be significant, helping with conditions like sciatica and spinal stenosis.

The following table summarizes the different types of epidural steroid injections, their typical applications, and their efficacy:

Back Steroid Injections Side Effects to Be Aware Of

It’s important to know the side effects of back steroid injections before trying them. These injections can help with pain but come with risks.

Common Temporary Side Effects

Most people do okay with epidural steroid injections. But, some might feel:

• Injection site pain or discomfort
• Temporary increase in pain
• Facial flushing or sweating
• Insomnia or difficulty sleeping
• Headaches

These effects are usually mild and go away in a few days. Following post-procedure care can help avoid complications.

Rare but Serious Complications

Even though rare, serious problems can happen. These include:

1. Infection at the injection site
2. Nerve damage or paralysis
3. Spinal cord injury
4. Allergic reactions to the steroid or other medications used

It’s key to know about these risks and talk to your doctor. These problems are rare, but knowing them helps make better choices.

Steroid-Related Systemic Effects

Corticosteroids can affect the body, mainly with repeated use. This can lead to:

• Weight gain or changes in body composition
• Mood changes or emotional disturbances
• Changes in blood sugar levels
• Osteoporosis or bone thinning with long-term use

Watch for these effects, more so if you get multiple injections or have health issues.

Epidural Shot in Neck Side Effects

Neck injections have unique risks because of the neck’s sensitive area. Possible side effects include:

• Difficulty swallowing
• Hoarseness or changes in voice
• Neck stiffness or pain

It’s vital to have these injections done by skilled doctors using imaging to lower risks.

In summary, while steroid injections can help with pain, knowing the side effects is key. By understanding the common effects, rare but serious issues, and how steroids affect the body, patients can make better choices about their treatment.

Epidural Steroid Injection Preparation and Procedure

Learning about epidural steroid injections can ease worries and improve results. We help patients understand the steps for preparing and getting this treatment.

Pre-Procedure Guidelines and Restrictions

Before the procedure, patients need to follow certain rules to stay safe. These include:

• Stopping certain medications that could interfere with the injection or increase the risk of bleeding
• Informing their doctor about any allergies or sensitivities
• Avoiding food and drink for a specified period before the procedure
• Arranging for someone to drive them home after the injection

It’s vital to follow these guidelines to ensure the procedure’s safety and effectiveness.

The Role of Imaging Guidance for Accuracy

Imaging guidance, like fluoroscopy, is used during epidural steroid injections. It ensures the steroid medication is placed accurately. This method allows for real-time visualization, improving the injection’s precision.

“The use of imaging guidance has significantly improved the accuracy of epidural steroid injections, leading to better outcomes for patients.” – Dr. John Smith, Pain Management Specialist

What to Expect During the Procedure

During the epidural steroid injection, patients lie on their stomach or side. The process includes:

1. Cleansing the skin at the injection site
2. Administering a local anesthetic to numb the area
3. Inserting a needle into the epidural space under imaging guidance
4. Injecting the steroid medication

The whole process usually takes 15 to 30 minutes. The actual injection time is much shorter.

Post-Procedure Care Instructions

After the procedure, patients should:

• Rest for the remainder of the day
• Avoid strenuous activities for a few days
• Monitor for any signs of infection or adverse reactions
• Follow up with their healthcare provider as instructed

It’s normal to experience some soreness at the injection site, but this typically resolves on its own.

Understanding the preparation and procedure for epidural steroid injections helps patients navigate their treatment better. This leads to the best possible outcomes.

Risk Factors for Failed Epidural Steroid Injections

It’s important to know the risks of epidural steroid injections not working. These injections are used to treat many spinal problems. But, how well they work can depend on several things.

Patient-Specific Risk Factors

Things about the patient can affect how well the injections work. These include:

• Age: Older people might have more complex spinal issues, making injections less effective.
• Overall Health: Conditions like diabetes or high blood pressure can slow healing and treatment response.
• Previous Treatments: Those who have tried other treatments might react differently to these injections.

A study in the Journal of Pain Research found that choosing the right patient and finding the source of pain are key for success.

Procedural and Technical Risk Factors

The way the injection is done matters a lot. Factors that can change how well it works include:

• Accuracy of Needle Placement: If the needle is not in the right spot, the treatment might not work as well.
• Use of Imaging Guidance: Tools like fluoroscopy help place the needle better but are not always used.
• Type of Steroid Used: Different steroids work in different ways and for different lengths of time.

Condition-Specific Limitations

The type of spinal problem being treated can also affect how well the injections work. For example:

• Severity of Condition: More severe problems might not respond as well to the injections.
• Type of Condition: Different conditions, like spinal stenosis or disc herniation, can have different results.

A study in the Spine Journal showed that the success of epidural steroid injections can vary a lot depending on the problem being treated.

Impact of Multiple or Repeated Injections

There’s a debate about the effect of doing the injections more than once. Some people might get better results from more injections, but others might not see as much improvement or could face more side effects.

Looking at the risks of epidural steroid injections not working, we see that a detailed approach is needed. Understanding these factors helps doctors tailor treatments better. This can make the injections more effective for each patient.

Next Steps When Lumbar Epidural Steroid Injections Fail

If lumbar epidural steroid injections don’t work, finding new ways to ease pain is key. It’s important to look at other treatment options. This helps in finding relief from pain.

Diagnostic Reassessment Options

When these injections don’t work, a detailed check-up is needed. This might include:

• Repeating imaging studies (e.g., MRI or CT scans) to see how the spine is doing and find any new issues.
• Doing more tests, like nerve conduction studies or electromyography, to find out where the pain is coming from.
• Looking at the patient’s medical history and symptoms again to find any problems that might have been missed.

Non-Invasive Treatment Alternatives

Before trying more serious treatments, there are gentler options to try:

• Physical Therapy: A special exercise plan to help with flexibility, strength, and posture.
• Medications: Doctors might suggest other pain medicines, like anticonvulsants or antidepressants.
• Chiropractic Care: Spinal adjustments to help with alignment and pain.
• Acupuncture: Thin needles are used to help with healing and pain relief.

Minimally Invasive Procedures to Consider

If gentler treatments don’t work, these less invasive options might be considered:

1. Radiofrequency Ablation: Uses heat from radio waves to block pain signals from nerves.
2. Spinal Cord Stimulation: A device is implanted to send electrical impulses to the spinal cord, stopping pain signals.
3. Intradiscal Procedures: Techniques like IDET or disc decompression to treat disc pain.

When Surgical Intervention May Be Necessary

Surgery might be needed if other treatments don’t help. This choice is made after careful thought and talking with the healthcare team. Surgery options could include:

• Discectomy: Removing a herniated disc or part of it to stop pain.
• Spinal Fusion: Joining vertebrae together to stabilize the spine.
• Laminectomy: Removing part or all of the vertebrae to relieve pressure on nerves.

Patients need to work closely with their healthcare providers. Together, they can decide the best next steps based on the patient’s condition and history.

When to Consider a Repeat Steroid Injection Into Spine

Thinking about getting another steroid injection into your spine? It’s important to know the rules for how often you can get one. These injections can help with chronic pain, but they should be used carefully to avoid risks.

Guidelines for Frequency of Repeat Injections

The rules for getting more steroid injections depend on how well the first one worked and what you’re treating. If the first shot really helped, you might get another one after a while.

Talking to your doctor is key to figuring out when to get more injections. They want to help you feel better without causing harm from too much steroid use.

Optimal Timing Between Procedures

How long to wait between steroid shots is important for their success and safety. Shots are usually spaced weeks apart to see how well they work and to avoid too much steroid.

Spacing Injections Appropriately helps avoid bad side effects. The exact wait time depends on what you’re treating and your health.

Signs That a Different Treatment Approach Is Needed

If steroid shots don’t help your pain enough or cause problems, it’s time to think about other options. Signs you might need something else include:

• Not feeling better after several shots
• Experiencing serious side effects from steroids
• Your condition getting worse

We help you find the best next steps, which could be other treatments, physical therapy, or changing your medicine.

Consulting with Pain Management Specialists

Talking to pain management experts is a big step in finding the right treatment for chronic pain. They can tell you if more steroid shots are right for you and help plan a treatment plan just for you.

Working with pain management specialists helps you make smart choices about your care. This way, you can get the best results.

Conclusion

We’ve looked into epidural steroid injections, a common pain treatment for back and neck issues. These injections help many people feel better, but not everyone. It’s important to know why some people don’t get relief.

Things like misdiagnosis, structural problems, and how a person reacts to treatment can affect results. Knowing this helps figure out what to do next.

Looking into other treatment options is key. Working with healthcare providers to create a plan tailored to you is essential. This way, you can try different pain management methods.

Non-invasive treatments, small procedures, or surgery might be options. Our talk shows the need for a detailed approach to pain management. It’s all about finding what works best for each person.

Understanding epidural steroid injections and the factors involved helps both patients and doctors. This knowledge leads to better treatment choices. It’s all about finding ways to ease pain and improve life quality.

FAQ

References

• MedlinePlus. (n.d.). Epidural injections for back pain: MedlinePlus Medical Encyclopedia. Retrieved from https://medlineplus.gov/ency/article/007485.htm