Last Updated on November 26, 2025 by Bilal Hasdemir
Wondering ‘how many epidurals can you have‘? Learn 6 critical facts about the safety, frequency, and limits of epidural steroid injections.
Epidural steroid injections are a common treatment for radiculopathy. This condition is caused by disc herniation or changes in the vertebrae. These injections aim to reduce inflammation and relieve pain.
Experts at Liv Hospital give clear, evidence-based answers to questions about epidural injections. It’s important for patients to understand the risks and benefits before choosing this treatment.
Many patients worry about how often they can get epidural injections. While they can provide significant relief, there are limits to how often they can be safely given.
Key Takeaways
- Epidural steroid injections are used to treat radiculopathy caused by disc herniation or degenerative changes.
- The safety and frequency of epidural injections are key for patients.
- Experts at Liv Hospital provide evidence-based guidance on epidural injection safety.
- Understanding the risks and benefits is essential for patients considering epidural injections.
- The frequency of epidural injections should be determined based on individual patient needs.
Understanding Epidural Injections: Purpose and Procedure
Epidural injections are used to treat pain from disc herniation or spinal degeneration. They are a key treatment for many spinal pain issues.
What Are Epidural Injections?
Epidural injections put medicine around the spinal cord. This helps reduce inflammation and eases pain in the neck, arms, back, and legs. The epidural space is a cushioning layer that contains fat, blood vessels, and nerves, making it perfect for pain relief.
Common Conditions Treated with Epidurals
Epidural injections help with herniated discs, spinal stenosis, and degenerative disc disease. These issues can cause pain, numbness, or weakness in the limbs. Epidural injections can greatly reduce this pain by lessening inflammation around the nerves.
The Injection Process Explained
The epidural injection process starts with the patient lying on their stomach or side. The area is cleaned and numbed. A needle is then guided into the epidural space under X-ray. This whole process usually takes less than 30 minutes, and patients can go home soon after.
Types of Medications Used in Epidurals
The medicines used are corticosteroids and local anesthetics. Corticosteroids reduce swelling, and local anesthetics numb the area. The type of medicine used depends on the patient’s condition and the doctor’s advice. Sometimes, a mix of both is used for the best pain relief.
How Many Epidurals Can You Have? Expert Guidelines
Experts have set guidelines for how often you can get epidural steroid injections. They aim to help you get the most benefit while keeping risks low.
Standard Frequency Recommendations
Most doctors say you should get three or four injections per year at most. This rule helps balance pain relief with the risks of too many shots.
Medical Consensus on Safe Intervals
How long to wait between shots is also key. Doctors usually advise waiting one to two weeks between shots. This lets you see if the last shot worked and keeps risks down.
Why Limitations Exist
There are limits on how often you can get epidural shots. This is because of the risk of cumulative steroid exposure and long-term side effects. While shots can help with pain, they can also affect your body if used too often.
Differences Between Therapeutic and Diagnostic Injections
It’s important to know the difference between therapeutic and diagnostic injections. Therapeutic shots aim to ease pain, while diagnostic shots help find where the pain comes from. How often you get these shots depends on your health and what your doctor thinks.
Knowing these guidelines is key for anyone thinking about epidural shots for pain. By following these rules, you can reduce risks and get the most from your treatment.
Annual Limits: Epidural Injection Frequency Per Year
There are yearly limits on epidural steroid injections to keep patients safe and effective. These limits help make sure the treatment works well without causing harm.
Three to Four Injections Rule
Most doctors agree that you should not get more than three to four injections a year. This rule helps keep the treatment safe and effective.
Key Considerations:
- The type of steroid used can impact the frequency of injections.
- Patient response to previous injections plays a critical role in future injection frequency.
- Underlying medical conditions may require adjusting the standard frequency guidelines.
Spacing Between Injections
It’s important to space injections apart to avoid side effects and check if the treatment is working. Injections are usually given several weeks apart. This lets doctors see how well the treatment is working and make changes if needed.
When Exceptions Might Apply
Even though there’s a general rule of three to four injections, some patients might need more. This depends on how severe their symptoms are, their overall health, and how well they respond to treatment.
For example, someone with very bad symptoms might need injections more often, but only under close doctor supervision.
Tracking Your Annual Injection History
It’s important for patients to keep track of their epidural injections. They should note the date, type of injection, and how they felt after it. This helps doctors make better decisions for future treatments and follow yearly limits.
By sticking to yearly limits on epidural injections, patients can get the most out of their treatment. This way, they can enjoy the benefits while avoiding risks.
Lifetime Considerations for Epidural Steroid Injections
When patients get many epidural steroid injections, it’s key to look at the big picture. We need to weigh the good against the bad. This helps decide if more injections are right for you.
Cumulative Effects of Multiple Injections
Getting more epidural steroid injections can have both good and bad effects. The good is that you might feel less pain and move better. But, there could be downsides like too much steroid in your body and changes to the tissue around the injection site.
Systemic steroid exposure can mess with your hormones. This might affect how your body handles sugar, your bones, and even your adrenal glands. Local changes could include cortical bone thinning and ligamentous laxity.
“The cumulative dose of steroids is a critical factor in determining the risk of systemic side effects.”
Narasimhan et al., 2016
Long-term Safety Concerns
There are long-term worries with epidural steroid injections. These include osteoporosis, avascular necrosis, and adrenal insufficiency. Keeping an eye on these risks is very important.
| Potential Risk | Description |
| Osteoporosis | Weakening of bone density due to steroid use |
| Avascular Necrosis | Loss of blood to the bone, potentially leading to bone death |
| Adrenal Insufficiency | Reduced production of cortisol by the adrenal glands |
Monitoring Lifetime Exposure
Keeping track of how much you’ve had is key. We look at the number of injections, the steroid dose, and how you react. This helps us make smart choices about your treatment.
Research on Extended Use of Epidurals
Researchers are always studying epidural steroid injections. They want to know more about their long-term effects. They’re looking at the best doses, different steroids, and other treatments to reduce risks.
By keeping up with new studies, doctors can give you the best care. They aim to balance the benefits of pain relief with the risks of long-term treatment.
Safety Profile of Epidural Injections
Epidural injections have a good safety record. They are safe when done right. This includes looking at side effects and possible complications.
Common Side Effects and Their Management
Side effects like pain, headaches, and facial flushing are common. They are usually mild and go away on their own. Effective management means watching symptoms and giving more medicine if needed.
Some people might feel more pain after the shot. This can be helped with over-the-counter pain meds. It’s key to follow the doctor’s instructions after the shot to avoid side effects.
Serious Complications: Frequency and Prevention
Though rare, serious issues like infections, nerve damage, and allergic reactions can happen. Prevention comes from using clean techniques and checking the patient’s health before the shot.
| Complication | Frequency | Prevention Measures |
| Infection | Rare | Sterile technique, prophylactic antibiotics in some cases |
| Nerve Damage | Very Rare | Precise needle placement, use of imaging guidance |
| Allergic Reaction | Rare | Careful patient history, use of non-ionic contrast media |
Contraindications for Epidural Injections
Some conditions make epidural injections not safe. These include bleeding problems, active infections, and serious spine issues. People with these should be checked carefully before the shot.
Pre-Procedure Safety Assessments
Before an epidural, a detailed safety check is done. This includes looking at the patient’s health history and current status. Imaging studies might also be used to make sure the shot is safe and works well.
Factors Affecting Safe Epidural Frequency
Knowing what affects the safe use of epidural injections is key for managing pain well. Each person’s needs and medical guidelines are considered. This makes sure the treatment fits right.
Patient-Specific Health Considerations
Every person’s health matters when deciding how often to use epidural injections. Things like overall health, past medical issues, and other health problems are looked at. For example, people with diabetes or on certain drugs need extra care.
Underlying Medical Conditions
Medical conditions can change how often epidural injections are safe. Issues like osteoporosis, bleeding problems, or high blood pressure might mean treatment needs to be adjusted. It’s important to check these conditions carefully to avoid problems.
Response to Previous Injections
How a patient reacts to epidural injections is very important. If a patient got a lot of relief or had bad side effects, this helps decide future treatments. Keeping track of how patients react helps make the treatment better.
Age and Physical Condition
Age and physical health are also big factors. Older people or those in poor health might process drugs differently or face more risks. Changing the frequency and amount of the treatment can help reduce these risks.
The main things that affect safe epidural frequency are:
- Patient-specific health considerations
- Underlying medical conditions
- Response to previous injections
- Age and physical condition
Healthcare providers look at these factors to find the safest and most effective treatment plan. This ensures the best pain relief with the least risk.
Potential Risks of Frequent Epidural Injections
It’s important to know the risks of getting epidural injections often. These injections can help with chronic pain but may cause problems if used too much.
Short-Term Side Effects
Epidural injections can have side effects right after. Some are mild and go away quickly. Others can be serious. Common side effects include:
- Injection site pain or discomfort
- Headaches
- Nausea and vomiting
- Facial flushing
- Temporary increase in pain
Most of these side effects can be treated with medicine or get better by themselves. But, it’s key to watch how long they last and how bad they are.
Long-Term Complications
Using epidural injections a lot can cause serious problems later on. These problems can affect your health for a long time. Some include:
| Complication | Description | Potential Impact |
| Corticosteroid side effects | Long-term use of corticosteroids in epidural injections | Weight gain, osteoporosis, cataracts |
| Nerve damage | Repeated injections may cause nerve irritation or damage | Chronic pain, numbness, or weakness |
| Infection risk | Increased risk of infection with frequent injections | Local or systemic infections |
Hormonal Impacts of Steroid Epidurals
Steroid epidural injections can affect your hormones. This is because of the corticosteroids they contain. These effects can lead to hormonal imbalances.
Corticosteroid-induced hormonal changes can cause a variety of symptoms. These can be mild or severe and might need medical help to manage.
Nerve Damage Concerns
Nerve damage is a big worry with frequent epidural injections. This can happen from the needle, the substances injected, or the corticosteroids.
Nerve damage symptoms can be different for everyone. They might include ongoing pain, numbness, tingling, or weakness. It’s important to watch for these signs to avoid lasting damage.
Alternative Approaches When Epidural Limits Are Reached
When you hit the limit on epidural injections, it’s time to look at other ways to manage pain. Patients and doctors need to find safe and effective treatments together.
Non-Steroid Pain Management Options
When you can’t get more epidural shots, try non-steroid pain management. This includes nonsteroidal anti-inflammatory drugs (NSAIDs) and other painkillers. “NSAIDs can help manage pain without steroids,” say pain experts.
Also, consider acupuncture or mindfulness therapy. These methods treat the whole person, not just the pain. They can work well with other treatments.
Physical Therapy and Rehabilitation
Physical therapy is key when epidural shots are not an option. A custom exercise plan can boost mobility and strength. It also helps reduce pain. Physical therapists create plans that meet your needs and goals.
Rehab programs might also include occupational therapy. This helps with daily tasks and lessens pain. This approach can greatly improve life for those with chronic pain.
Interventional Procedures Beyond Epidurals
Other procedures can help when epidural shots are not possible. Radiofrequency ablation uses heat to block nerve pain. Spinal cord stimulation involves a device that sends electrical impulses to the spinal cord.
“Interventional pain management has grown a lot, giving patients more choices than just epidural shots,” says a top pain expert.
Surgical Interventions to Consider
If other treatments don’t work, surgery might be needed. This could be discectomy or spinal fusion. These surgeries aim to fix the pain’s cause.
Talking about surgery’s benefits and risks with your doctor is key. This helps you make a well-informed choice.
Conclusion: Making Informed Decisions About Epidural Treatments
Epidural steroid injections are a common treatment for radiculopathy. They help relieve pain and inflammation. Knowing how often you can get these injections is key to making good choices about your treatment.
The number of injections you can get depends on several things. These include how bad your condition is, your overall health, and how well you’ve responded to previous injections. Even though guidelines say you can have up to three to four injections a year, this can change based on your situation.
To make smart choices about epidural treatments, you need to know about their safety, risks, and other options. Talking to your healthcare provider about these things can help you find the best treatment for you.
Being informed helps you take charge of your health. It ensures you get the best treatment with the least risk. By staying informed and working with your healthcare provider, you can get better and live a better life.
FAQ
How many epidurals can you have in a lifetime?
The number of epidurals you can have varies. There are guidelines to limit them due to side effects and complications.
How often can you get epidural steroid injections?
You can get epidural steroid injections every few weeks to months. It’s usually recommended to have no more than three to four injections a year.
Are epidural steroid injections safe?
Epidural steroid injections are generally safe when done by experts. But, they can cause risks and side effects like infection, nerve damage, and hormonal changes.
How many steroid injections can you have in a lifetime?
There’s no strict limit on steroid injections in a lifetime. But, getting them too often can cause side effects. Most guidelines suggest limiting the number over a lifetime.
What are the possible risks of frequent epidural injections?
Frequent epidural injections can cause nerve damage, hormonal imbalances, and make you more likely to get infections. There are other risks too.
How long can you have an epidural?
The length of time for an epidural varies. Usually, injections are given in a series with breaks in between, not continuously.
Are there other ways to manage pain when you can’t have more epidural injections?
Yes, there are other ways. You can try non-steroid pain management, physical therapy, rehabilitation, and other procedures or surgeries.
How many epidural steroid injections are safe in a year?
It’s generally safe to have no more than three to four epidural steroid injections a year. They should be spaced out to reduce risks.
What factors affect how often you can get epidural injections?
Several factors affect the safe frequency of epidural injections. These include your health, medical conditions, how you’ve reacted to previous injections, age, and physical condition.
Can you get epidural steroid injections too often?
Yes, getting them too often can increase the risk of side effects and complications. This includes hormonal changes and nerve damage.
References
Shrestha, O., Basukala, S., Thapa, N., et al. (2023). Endovenous laser ablation versus conventional surgery (ligation and stripping) for primary great saphenous varicose vein: A systematic review and meta-analysis. Annals of Medicine and Surgery, 85, 4509-4519. https://pubmed.ncbi.nlm.nih.gov/37663729/
