Last Updated on November 4, 2025 by mcelik
Finding new ways to deal with pain can be hard. In this article, we’ll look at options for those who haven’t found relief from epidural steroid injections. We’ll talk about why these injections might not work and the next step after epidural steroid injection to help ease your back pain.
Understanding the effectiveness and duration of epidural steroid injections is important for patients.
Epidural steroid injections put a local anesthetic and steroid into the space around the spinal cord and nerves. This helps reduce swelling and eases pain from spinal problems.
The epidural space is filled with fat and is outside the sac that holds spinal fluid and nerves. Injecting steroids here targets the inflamed areas around the nerves. This helps relieve pain and discomfort.
Epidural steroid injections help with many spinal issues, including:
These conditions can cause back and leg pain, numbness, and weakness. This happens because the spinal nerves get compressed or irritated.
There are different types of epidural steroid injections, based on where they’re given:
Each injection is made to fit the specific condition and pain area. This way, they offer targeted relief.
Understanding the effectiveness and duration of epidural steroid injections is important for patients. These injections are used to treat many spinal problems. But, how well they work can vary a lot from person to person.
The time you feel relief from these injections can change based on your condition and personal factors. Research shows that ESIs can help for months. But, how long it lasts can be different for everyone. Some people might feel relief for just a few weeks, while others might feel better for months or even years.
The success of epidural steroid injections can also depend on the condition being treated. For example, they work well for pain caused by herniated discs or spinal stenosis. Studies suggest that people with these issues can see a big drop in pain. This can help them live better and even start physical therapy.
Many things can affect how well epidural steroid injections work. These include how well the diagnosis is made, how bad the condition is, and the patient’s overall health. Getting a correct diagnosis and choosing the right patient are key for a good outcome. Also, the skill of the person doing the injection can play a big role in how well it works.
When epidural steroid injections don’t work, it’s often because of certain reasons. Knowing these reasons is key to figuring out what to do next.
One big reason ESIs might not work is if the pain source is wrong. If the real cause of pain isn’t found, the injection won’t help much.
How well the injection is placed matters a lot. If the steroid isn’t put in the right spot, it won’t work as well.
The seriousness of the condition being treated also plays a part. More serious conditions might not get better with ESIs.
Things like a person’s health, other medical issues, and how they’ve reacted to treatments before can also affect ESIs. These factors can change how well the treatment works.
| Factors Affecting ESI Effectiveness | Description | Impact on Treatment |
| Incorrect Diagnosis | Reduces the likelihood of successful treatment | |
| Technical Issues | Incorrect placement of steroid medication | Significantly impacts treatment effectiveness |
| Severity of Condition | More severe underlying conditions | May not respond well to ESIs |
| Individual Patient Factors | Overall health and response to treatment | Affects the outcome of the treatment |
Knowing these factors helps doctors make better treatment plans.
If you’re feeling pain after an epidural steroid injection, knowing the signs it didn’t work is key. This knowledge helps you decide what to do next.
Not seeing a big drop in pain after the injection is a clear sign it didn’t work. If your pain stays the same or gets worse, it means the injection didn’t fix the pain’s root cause.
Some people feel better for a bit after the injection, but then their pain comes back. This shows the real problem is not fixed. If your pain comes back soon after the relief fades, it means the treatment didn’t fully work.
Some folks get a little better but can’t do everyday things. They might feel pain even when they’re trying to relax. This means the injection helped a bit, but not enough.
People with pain on both sides might feel better on one side but not the other. This uneven feeling means the treatment didn’t cover both sides well.
| Signs of Ineffective Epidural Injection | Description |
| No reduction in pain levels | Pain remains the same or worsens after the injection |
| Temporary relief followed by return of symptoms | Symptoms return after initial temporary relief |
| Partial relief but continued functional limitations | Some pain relief but difficulties with daily activities |
| One-sided relief in bilateral conditions | Relief experienced on only one side of the body in bilateral conditions |
Understanding the effectiveness and duration of epidural steroid injections is important for patients.
The effects of an epidural steroid injection can be seen in a few days to a week. Sometimes, it takes up to two weeks to see the full effects. Keeping a symptom journal can help track any changes in your pain or how well you can move.
While rare, some signs need you to contact your healthcare provider right away. These include:
If you notice any of these symptoms, it’s important to get medical help quickly.
To get the most out of your follow-up appointment, track the following:
| Category | Details to Track |
| Pain Levels | Rate your pain on a scale of 0-10 daily |
| Medication Use | Record any pain medications taken, including dosage and frequency |
| Functional Ability | Note any changes in your ability to perform daily activities |
| Side Effects | Document any side effects experienced after the injection |
Being prepared with this information helps your healthcare provider make better decisions for you.
Knowing what to expect after an epidural steroid injection is key. It helps manage your recovery and ensures the best results. We’ll walk you through what to expect, including common symptoms, rest time, and when you can get back to normal.
Some discomfort or soreness is common after an epidural steroid injection. These feelings are usually short-lived and can be eased with over-the-counter pain meds. You might also notice:
These symptoms usually go away within a few days. But, if you have severe pain, trouble walking, or other concerns, call your doctor right away.
The rest time needed after an epidural steroid injection varies. Generally, rest for at least 24 hours after the injection. Try to avoid hard work, heavy lifting, and bending during this time.
| Activity | Recommended Restriction Period |
| Strenuous exercise | 2-3 days |
| Heavy lifting | 3-5 days |
| Bending or twisting | 2-3 days |
Most people can get back to normal in a few days to a week after the injection. But, always follow your doctor’s advice on activity levels and any restrictions. Slowly increasing your activity helps prevent problems and ensures a smooth recovery.
Understanding your recovery helps you care for yourself better after the procedure. If you have any worries or questions, don’t hesitate to ask your healthcare provider for help.
If an epidural steroid injection doesn’t work, it’s time to talk to your doctor again. This is key to finding a new way to manage your pain.
After a failed epidural steroid injection, seeing your doctor again is a must. Be ready to share how you’re feeling and any changes. Keeping a pain journal can help track how well the treatment is working.
It’s possible the first diagnosis was wrong or the condition has changed. A new look at your diagnosis might reveal the real cause of your pain. This could mean more tests or exams.
After rechecking your diagnosis, your treatment plan might change. You might try different injections, new medicines, or other treatments. Working with your doctor to find the right new treatment is important.
It’s important to know what to expect from your treatment. As
“Knowing what your treatment can and can’t do helps manage your hopes and satisfaction with your care.”
When epidural steroid injections (ESI) don’t work, we look for new ways to help. The right treatment depends on the spinal problem causing pain.
For herniated discs, we might try physical therapy. This strengthens the muscles and improves flexibility. Sometimes, minimally invasive surgery is needed to fix the disc.
Managing spinal stenosis involves many steps. Chiropractic care can help align the spine and ease nerve pressure. Pain management, like medication and lifestyle changes, is also key.
Treating degenerative disc disease often combines physical therapy and pain management. Sometimes, regenerative medicine, like stem cell therapy, is considered to heal and reduce inflammation.
For sciatica, we first figure out why the nerve is hurting. Treatment might include targeted physical therapy or nerve blocks to help.
Every spinal condition is different. So, each treatment plan must fit the patient’s unique needs and situation.
If epidural steroid injections don’t work, there are other options. These therapies focus on different areas and can help with various pains.
Facet joint injections put a local anesthetic or corticosteroid into the spine’s facet joints. They help treat facet joint syndrome, a common back pain cause.
The procedure uses fluoroscopy for precise placement. It can greatly reduce pain, helping patients get back to their daily activities.
Sacroiliac joint injections target the sacroiliac joints in the pelvis. They can diagnose and treat sacroiliac joint dysfunction, a lower back pain source.
Like facet joint injections, these are done under imaging. They aim to reduce inflammation and pain with local anesthetics and corticosteroids.
Trigger point injections put a local anesthetic or corticosteroid into inflamed muscle knots. These knots can cause muscle pain and stiffness.
The procedure is quick and can be done in a clinic. It helps those with myofascial pain syndrome find relief.
Nerve blocks inject a local anesthetic or corticosteroid around nerves to block pain signals. They’re effective for neuropathic pain and inflammation-related pain.
They can be used to find pain sources or to treat it. Diagnostic blocks identify pain sources, while therapeutic blocks relieve pain.
| Therapy Type | Target Area | Pain Relief Mechanism |
| Facet Joint Injections | Reduces inflammation and pain in facet joints | |
| Sacroiliac Joint Injections | Sacroiliac joints | Decreases inflammation and stabilizes the joint |
| Trigger Point Injections | Trigger points in muscles | Relaxes muscle knots and reduces pain |
| Nerve Blocks | Specific nerves | Blocks pain signals to the brain |
Alternative injection therapies offer many options for those not helped by epidural steroid injections. They target different areas and pain mechanisms, providing significant relief and improving life quality.
When epidural steroid injections don’t work, there are many non-invasive ways to handle back pain. These methods aim to improve function, lessen pain, and boost overall health without surgery.
Physical therapy is key in managing back pain without surgery. Our physical therapists create custom exercise plans. These plans help with flexibility, muscle strength, and posture.
They use manual therapy, exercises, and treatments like heat or electrical stimulation. Studies show physical therapy can greatly reduce pain and improve function in chronic back pain patients.
Chiropractic care deals with spine-related disorders. Chiropractors use spinal manipulation and manual therapies. These methods help restore joint mobility, reduce inflammation, and improve spinal function.
This approach is great for those with mechanical back pain or spinal misalignments.
Acupuncture is a traditional Chinese medicine technique. It involves inserting thin needles into specific body points to stimulate healing and pain relief. Other therapies like massage, yoga, and meditation also help manage back pain.
These methods reduce stress, improve flexibility, and promote relaxation. They contribute to pain reduction.
Pain psychology and cognitive behavioral therapy (CBT) focus on the mental side of chronic pain. These therapies help patients develop coping strategies and manage pain-related distress. They improve quality of life.
By changing how patients perceive and respond to pain, CBT can greatly impact pain management.
Exploring these non-invasive options can help patients manage back pain and enhance their well-being. It’s important to work with healthcare providers to find the best treatment plan for each individual.
For those with ongoing back pain, a good medication plan can make a big difference. If treatments like epidural steroid injections don’t work, medicine can help. It can ease symptoms and make life better.
When over-the-counter drugs don’t cut it, doctors might prescribe stronger pain meds. These can really help with severe pain. Here are some common ones:
Muscle relaxants are good for muscle tension or spasms. They relax muscles and are often used with other treatments.
For nerve pain, special meds can work well. These include certain antidepressants and anticonvulsants.
Anti-inflammatory drugs can cut down inflammation and pain. They’re good for conditions like arthritis or inflammatory back pain.
It’s key to talk to your doctor about your medication plan. They’ll consider:
With a good medication plan, you can manage your back pain better. This can greatly improve your life quality.
For those with chronic back pain, advanced treatments offer hope when usual methods don’t work. These new methods aim to bring relief and better life quality.
Living with chronic back pain is tough, affecting daily life in many ways. Our advanced treatments are key to managing pain.
Radiofrequency ablation uses heat from radio waves to target nerves. This stops pain signals to the brain. It’s good for chronic pain, like arthritis or facet joint syndrome.
This method targets pain nerves, giving long-lasting relief. Patients can then do more without pain.
Spinal cord stimulation implants a device that sends electrical impulses to the spinal cord. It blocks pain signals. This helps those who haven’t found relief with other treatments.
The device can be adjusted to better manage pain. It greatly improves life quality, letting patients do things they couldn’t before.
Intrathecal pain pumps deliver medication directly to the spinal fluid. They offer targeted pain relief. This is great for severe, chronic pain that other treatments can’t handle.
The pump can be refilled and adjusted as needed. It’s very effective for cancer pain or those needing lots of pain meds.
Regenerative medicine uses treatments to help the body heal and reduce inflammation. Methods like PRP therapy and stem cell therapy are being studied for back pain.
These methods aim to use the body’s healing powers to fix damaged tissues. Though new, they show promise for those looking for non-traditional pain relief.
Exploring these advanced treatments, we can find a solution that fits your needs and improves your life.
When other treatments don’t work, surgery might be the next step for back pain. It’s considered when other treatments fail and the condition is severe. This is when surgery is needed.
There are many surgical options for back pain, based on the condition. These include:
To decide if surgery is right, we look at several things. We consider how severe the condition is, the patient’s health, and how they’ve responded to other treatments. A detailed evaluation, including imaging and a physical check-up, helps us see if surgery will help a lot.
Before surgery, we talk about the risks and benefits. Surgery can help a lot with pain and function, but it also has risks like infection and nerve damage. We make sure patients know what to expect and are ready.
Recovery from back surgery depends on the procedure and the patient’s health. Patients usually need to rest and then start a rehabilitation program, which might include physical therapy. Knowing what to expect helps patients prepare and get the best results.
By looking at the different surgeries, deciding if they’re right, understanding the risks and benefits, and knowing what recovery is like, patients can make good choices about their care.
Creating a detailed pain management plan is key to handling back pain well. We team up with healthcare experts to craft plans that fit each person’s needs and goals. These plans might include injections, physical therapy, managing medicines, and changing lifestyle habits.
Looking at different treatments and working with doctors can lead to big improvements. A good pain management plan lets people take back control of their lives. They can then enjoy activities they love again.
Managing back pain means always checking and tweaking the treatment plan. We stress the need for teamwork between patients and doctors. This ensures the best results in managing pain.
If an epidural steroid injection doesn’t help, talk to your doctor again. They will check your diagnosis and change your treatment plan if needed.
How long relief lasts from an epidural steroid injection varies. It depends on your condition and how your body reacts. But, it can last several months.
If you don’t feel any pain relief, or if the pain comes back, it might not have worked. Also, if you only feel relief on one side of your body, it’s not effective for both sides.
Rest time after an epidural steroid injection varies. But, usually, you’ll need to rest for a bit. Then, follow your doctor’s advice on when to start doing normal activities again.
There are other injection therapies like facet joint injections and sacroiliac joint injections. Also, trigger point injections and nerve blocks can help with different types of pain.
For back pain, you can try physical therapy, chiropractic care, or acupuncture. There are also alternative therapies and pain psychology to help manage pain.
For back pain, doctors might prescribe pain medications, muscle relaxants, or medications for nerve pain. They might also suggest anti-inflammatory drugs.
Surgery is usually a last choice for severe back pain that hasn’t improved with other treatments. It’s a big decision that involves weighing risks and benefits.
For advanced back pain, there are procedures like radiofrequency ablation and spinal cord stimulation. There are also intrathecal pain pumps and regenerative medicine options.
Epidural steroid injections start working in a few days to a week. But, it can vary from person to person.
Epidural steroid injections might not work if the pain source is misdiagnosed. Technical issues or the severity of your condition can also play a role.