Do Epidural Steroid Injections Really Work? Here’s What the Research Shows.
Epidural steroid injections (ESIs) are a common treatment option for people dealing with pain that radiates down the arms or legs, commonly caused by a herniated disc or nerve root irritation. So, in what situations and clinical conditions do they make sense?
Short-term pain and disability
There’s strong evidence that ESIs can reduce pain and improve function in the short term, especially for people with lumbar radiculopathy, commonly referred to as sciatica. The American Academy of Neurology reviewed the data and found that ESIs have a small to moderate effect on short-term pain, with the best results typically showing up within two to six weeks after the injection.
What about long term effects and benefits?
When it comes to long-term pain relief, the evidence is mixed. Some studies show that ESIs may help reduce long-term disability in people with chronic radicular pain, but they’re less convincing when it comes to sustained pain reduction.
Most clinical trials and meta-analyses find that while ESIs can lower pain scores in the short term, the improvements tend to fade over several months.
Who benefits the most?
People with acute radicular pain from a disc herniation, especially in the lower back, tend to get the most benefit. There’s also solid support for the use of transforaminal ESIs, which is a more targeted approach to the nerve root, in these cases. For those trying to avoid or delay surgery or who haven’t improved with conservative treatments like physical therapy or medications, an epidural steroid injection can be a helpful next step in controlling acute pain, getting stronger, and becoming more active. There may also be a role for ESIs for chronic radiculopathy, especially if they’re used as a bridge for other interventions.
Safety profile and risks
ESIs are generally safe when performed by trained specialists using image guidance. Most side effects are minor and uncommon, like injection site soreness. But as with any procedure, there are risks such as bleeding, infection, or damage to nearby nerves or structures. That’s why it’s important to work with a board-certified interventional pain specialist who understands the anatomy and can accurately assess the risks and benefits of the procedure.
The takeaway
Epidural steroid injections can be very beneficial for patients with acute radicular pain especially if it is affecting their ability to work or function. They may also be beneficial for someone with chronic radicular pain. They can serve as a bridge while other treatments are being pursued, helping people avoid or delay surgery until their other clinical conditions are optimized.
If you’re dealing with radicular symptoms, we’re happy to help you understand your options. At InterSpine Pain and Wellness Center, we use advanced image guidance and a personalized approach to spine care.
Feel free to reach out to schedule a consultation and see if an ESI might be the right next step in your recovery.
