Last Updated on November 26, 2025 by Bilal Hasdemir
Many people and doctors wonder if a cortisone injection or an epidural is better for back pain.
At Liv Hospital, we know how complex back pain can be. We offer different treatments, like cortisone injections and epidural steroid injections. Each has its own way of working and how well it works.
Studies have found that epidural steroid injections can help with back and neck pain for a short time. But, their benefits often fade after a few months.
We want to help you make the best choice for your back pain treatment. Knowing the differences between cortisone injections and epidural steroid injections is key. This helps you decide what’s best for you.
Key Takeaways
- Cortisone injections and epidural steroid injections are two common treatments for back pain.
- The choice between the two treatments depends on individual patient needs and medical history.
- Epidural steroid injections may offer short-term relief, but their long-term effectiveness is limited.
- Understanding the differences between cortisone injections and epidural steroid injections is critical for making informed decisions.
- Liv Hospital is committed to providing patient-centered care and guiding you through your treatment options.
Understanding Back Pain and Injectable Treatments
It’s important to understand back pain to find the best treatment, like injectable options. Back pain comes from many sources. Knowing this helps both patients and doctors.
Common Causes of Back Pain
Back pain can come from musculoskeletal issues, degenerative disc disease, and inflammatory conditions. Some common reasons include:
- Herniated or bulging discs
- Spinal stenosis
- Facet joint pain
- Sciatica
- Muscle strain or sprain
Chronic back pain is a big problem worldwide. It affects 1 in 5 adults aged 20-59. Knowing the cause is key to choosing the right treatment.
When Injections Become a Treatment Option
Injectable treatments like cortisone shots are used when other treatments don’t work. These injections help reduce inflammation and pain. This lets patients do their daily activities again.
Doctors decide on injections after checking the patient. They look at the pain’s severity, how it affects daily life, and any other health issues.
The Role of Anti-inflammatory Medications
Anti-inflammatory medications are key in managing back pain, mainly when inflammation is involved. Corticosteroid injections, like cortisone shots, are strong anti-inflammatory agents. They help a lot with inflammatory back pain.
These medications reduce inflammation. This makes pain and function better. It helps patients do physical therapy and other rehab programs. Anti-inflammatory medications, including injectable steroids, are a big part of treating back pain.
What Is a Cortisone Injection?
A cortisone injection is a medical procedure to ease pain and swelling in certain body parts. It involves putting a corticosteroid medication into the affected area, like a joint or soft tissue.
Definition and Composition
Cortisone injections contain a synthetic version of cortisol, a hormone made by the adrenal gland. The corticosteroid in these shots mimics cortisol’s anti-inflammatory effects. The mix might include triamcinolone or methylprednisolone, and sometimes lidocaine for quick pain relief.
How Cortisone Injections Work
Cortisone injections reduce inflammation in the targeted area. When corticosteroids are injected, they calm the immune system’s inflammatory response. This leads to less pain and swelling, improving mobility and function.
The effects of a cortisone injection can last from weeks to months. This provides significant relief for those suffering from inflammation.
Target Conditions for Cortisone Shots
Cortisone injections are used for many inflammatory conditions. These include arthritis, tendinitis, and bursitis. They are most effective for conditions in the peripheral joints, like knees and elbows.
By targeting the inflammation source, cortisone injections offer substantial relief. This helps patients with these conditions a lot.
What Is an Epidural Steroid Injection?
Understanding epidural steroid injections is key for those looking at back pain treatments. This procedure delivers anti-inflammatory medicine into the space around spinal nerves. It’s a way to manage back pain.
Definition and Composition
Epidural steroid injections mix a corticosteroid with a local anesthetic. The corticosteroid fights inflammation and pain around the spinal nerves. The local anesthetic gives quick, but short, pain relief.
“The precise delivery of steroids into the epidural space allows for targeted treatment of inflamed areas around the spinal nerves,” say doctors. This focused treatment is key for managing pain from different spinal issues.
How Epidural Injections Work
Epidural steroid injections reduce inflammation around spinal nerves, which causes pain. By injecting the medicine into the epidural space, it targets the pain source. This helps with pain from herniated discs, spinal stenosis, and sciatica.
The procedure uses imaging like fluoroscopy or CT scans for accurate injection placement. This accuracy is important for treatment success and avoiding side effects.
Target Conditions for Epidurals
Epidural steroid injections treat several spinal conditions that cause pain. These include:
- Herniated discs
- Spinal stenosis
- Sciatica
- Degenerative disc disease
By focusing on inflamed areas around spinal nerves, these injections can greatly reduce pain for those with these conditions.
Cortisone Injection vs Epidural: Key Differences
When looking at treatments for back pain, it’s key to know the differences between cortisone and epidural steroid injections. Both help with pain, but they work in different ways.
Injection Site and Technique
Cortisone injections go straight into the painful area, like a joint or inflamed tissue. They inject corticosteroids right where the pain is. Epidural steroid injections, though, go into the space around the spinal cord. This needs a more precise method to get the medicine right.
For epidural steroid injections, imaging technology guides the injection site to ensure it’s accurate and safe. This difference in where and how the injection is done matters a lot. It affects how the medicine spreads and works.
Medication Delivery Method
Cortisone injections put corticosteroids right on the inflammation, giving local relief. Epidural steroid injections also use corticosteroids but spread them around the spinal cord. This can help more nerves and give wider pain relief.
Choosing between these methods depends on the condition and the patient’s health. For example, epidural injections are often used for spinal stenosis or herniated discs that affect many nerves.
Imaging Guidance Requirements
Both types of injections might use imaging like fluoroscopy or ultrasound to place the needle right. But, epidural injections need more precise imaging because of the tricky space they’re injected into.
Getting the needle in the right spot is key for both injections to work well and avoid problems. Using imaging to guide the needle is now common to make treatments safer and more effective.
Pain Conditions Addressed
Cortisone injections are for localized pain and inflammation in joints, tendons, or bursae. Epidural steroid injections are for pain that spreads down the spine, like sciatica, or spine problems like herniated discs.
What kind of pain you have helps decide which injection is better. For example, someone with facet joint pain might do better with cortisone. But, someone with sciatica might need an epidural steroid injection.
A study by the American Academy of Neurology found epidural steroid injections helped 24% more people for two to six weeks. But, their effect fades after three months. Knowing the differences between these injections is important for choosing the right treatment for back pain.
What to Expect During the Procedure
Knowing what happens during cortisone and epidural injections can ease worries. These treatments are quick, usually taking 15 to 30 minutes. They are simple and straightforward.
Preparation Before the Injection
Patients lie on their stomach or side before the shot. The area is cleaned with an antiseptic. A local anesthetic might be used to numb it. This makes the process as painless as possible.
The Cortisone Injection Experience
A doctor injects corticosteroid into the affected area with a needle. They use fluoroscopy or ultrasound for accuracy. You might feel a pinch or pressure, but it’s brief.
The Epidural Injection Experience
Epidural injections are similar but target the epidural space around the spinal cord. Imaging technology guides the needle. You might feel some pressure, but it’s usually manageable.
Pain Management During the Procedure
Managing pain is key during both procedures. Local anesthetics and sedation help. Afterward, you’re watched for any immediate side effects.
| Procedure Aspect | Cortisone Injection | Epidural Injection |
| Typical Duration | 15-30 minutes | 15-30 minutes |
| Preparation | Local anesthetic, antiseptic cleaning | Local anesthetic, antiseptic cleaning |
| Medication Delivery | Corticosteroid into affected area | Corticosteroid into epidural space |
| Pain Management | Local anesthetic, possible sedation | Local anesthetic, possible sedation |
Effectiveness for Different Back Conditions
Different back conditions react differently to cortisone and epidural steroid injections. It’s key to know how well these treatments work. We’ll look at their success for common back issues.
Herniated Discs
Cortisone shots can help with pain from herniated discs. Epidural steroid injections are great at cutting down inflammation. They also ease pressure on nerves.
Many people find these injections very helpful. But, how long the relief lasts can vary.
Spinal Stenosis
Epidural steroid injections are a good choice for spinal stenosis. They help lessen inflammation that causes pain.
Cortisone shots can also help. But, how well they work depends on how severe the stenosis is. People with mild to moderate stenosis usually see better results.
Sciatica
Sciatica, caused by irritated sciatic nerves, can be treated with epidural steroid injections. These injections target the pain area, giving relief.
Cortisone shots are also an option. Choosing between them depends on the sciatica’s cause.
Facet Joint Pain
Cortisone injections are often used for facet joint pain. Injecting cortisone into the facet joint can greatly reduce pain and inflammation.
This treatment is well-proven for facet joint pain. It offers a non-invasive alternative to other options.
In summary, cortisone and epidural steroid injections are useful for various back problems. Knowing the best treatment for your condition is key to making informed decisions about your health.
Potential Side Effects and Risks
It’s important to know the side effects of cortisone and epidural steroid injections before you decide on treatment. These injections can help with back pain, but they come with risks.
Common Side Effects of Cortisone Injections
Cortisone injections are usually safe, but they can cause some side effects. You might experience:
- Pain or discomfort at the injection site
- Temporary flare-up of pain
- Facial flushing
- Insomnia
- High blood sugar levels (for diabetic patients)
Common Side Effects of Epidural Injections
Epidural steroid injections can also have side effects. Some are similar to cortisone’s. You might face:
- Dural puncture headache
- Nerve damage
- Infection
- Bleeding or hematoma
- Temporary increase in pain
Serious Complications to Be Aware Of
Though rare, serious problems can happen with both types of injections. These include:
| Complication | Cortisone Injection | Epidural Steroid Injection |
| Infection | Possible | Possible |
| Nerve Damage | Rare | Possible |
| Allergic Reaction | Possible | Possible |
Risk Factors to Consider
Some factors can make complications more likely. These include:
- Diabetes (due to blood sugar spikes)
- Bleeding disorders or anticoagulant use
- Weakened immune system
- Previous bad reactions to steroid injections
Talking to your healthcare provider about these risks is key. They can help you understand how they might affect you.
Cost, Insurance Coverage, and Accessibility
Managing back pain involves thinking about the cost of treatments like cortisone and epidural steroid injections. The price can change a lot based on where you are, who you see, and your insurance.
Average Costs of Each Procedure
The cost of cortisone injections and epidural steroid injections can be quite different. A cortisone shot might cost between $100 and $300. An epidural steroid injection could be $500 to $1,500 or more. These prices depend on the procedure’s complexity, the doctor’s skill, and where it’s done.
Keep in mind, these are just estimates. The real cost might be different. It’s best to talk to your doctor for a more accurate price.
Insurance Coverage in the United States
In the U.S., insurance for cortisone and epidural steroid injections varies. Most plans cover these treatments if they’re needed. But, how much they cover can vary a lot.
It’s smart to check with your insurance to know what you’ll pay. This includes any costs you might have to cover yourself.
Frequency Limitations and Authorization
Insurance companies often have rules about how often you can get these injections. They might need you to get approval before they cover the cost. There might be limits on how many times you can get these injections in a certain time.
Knowing these rules helps you plan your treatment. It can also help you avoid surprise medical bills.
Questions to Ask Your Insurance Provider
To understand the financial side of cortisone and epidural steroid injections, ask your insurance these questions:
- What are the specific costs associated with cortisone injections and epidural steroid injections under my plan?
- Are there any pre-authorization requirements for these procedures?
- How often can I receive these injections within a certain period?
- What are my out-of-pocket expenses, including deductibles and copays?
Being informed and proactive helps you manage the financial side of treating your back pain.
Conclusion: Making an Informed Decision About Back Pain Injections
Understanding the differences between cortisone and epidural injections is key for managing back pain. Patients need to weigh the effectiveness, risks, and their own needs. This helps them choose the best treatment for their back pain.
We’ve looked at the main differences between cortisone and epidural injections. This includes their makeup, where they’re injected, and what they treat. This info helps patients pick the right option for their situation.
Choosing the right treatment for back pain means looking at the good and bad sides of each option. This way, patients can actively manage their pain and live better lives.
Deciding on a cortisone or epidural injection should always involve a doctor. We suggest talking to your doctor about your specific needs. This way, you can find the best treatment for you.
FAQ
What is the main difference between a cortisone injection and an epidural steroid injection?
Cortisone injections go directly into the affected area, like a joint or tendon. Epidural steroid injections go into the space around the spinal cord.
Are cortisone shots and steroid shots the same thing?
Yes, they are often called the same thing because cortisone is a steroid. Both are used to cut down inflammation and ease pain.
Is a cortisone injection the same as an epidural?
No, they are not the same. Both can treat back pain, but they differ in where they are injected and what they treat.
What conditions are typically treated with cortisone injections?
They’re used for tendonitis, bursitis, arthritis, and facet joint pain. They also help with other inflammatory conditions.
How do epidural steroid injections work?
They put corticosteroids into the space around the spinal cord. This reduces swelling and relieves nerve pressure, easing pain.
What are the possible side effects of cortisone injections?
Side effects include pain or swelling at the site and higher blood sugar. Serious issues like infection or nerve damage are rare but can happen.
How much do cortisone injections and epidural steroid injections cost?
Costs vary by location, insurance, and procedure. They can be a few hundred to several thousand dollars.
Are cortisone injections and epidural steroid injections covered by insurance?
In the U.S., many plans cover these injections. But coverage depends on your plan and the condition. Always check with your insurance.
Can I receive multiple cortisone injections or epidural steroid injections?
How often you can get injections depends on your condition and how you respond. There are usually limits on how many you can get in a certain time.
What should I ask my insurance provider about cortisone injections and epidural steroid injections?
Ask about the procedures, how many injections are covered, any pre-authorization needs, and any costs you’ll have to pay.
References
- Seager, M., Kumar, S., Lim, E., Munneke, G., Bandula, S., & Walkden, M. (2021). Renal cryoablation – a practical guide for interventional radiologists. PMC. https://pmc.ncbi.nlm.nih.gov/articles/PMC7934314/
