Epidural Steroid Injection

This information will help you prepare for your epidural steroid injections at Memorial Sloan Kettering (MSK).

The individual bones in your back are separated by rubbery cushions called discs. If a disc bulges it can irritate and inflame your spinal nerves. The irritation and inflamed nerves cause back and nerve pain. A steroid injection can help to decrease nerve inflammation, which may help to reduce your pain.

Your epidural space goes from the base of your head to the part of your spine that is below your hips (see figure). A steroid may be injected into any area of your epidural space. Your pain doctor will decide the best location for your injection based on where your pain is.

1 Week Before Your Procedure

Ask about your medications

You may need to stop taking some medications before your procedure.

We have included some common examples below.

  • If you take medication to thin your blood, ask the doctor who prescribes it for you when to stop taking it. Some examples are warfarin (Coumadin®), dalteparin (Fragmin®), heparin, tinzaparin (Innohep®), enoxaparin (Lovenox®), clopidogrel (Plavix®), and cilostazol (Pletal®).
  • If you take insulin or other medications for diabetes, you may need to change the dose. Ask the doctor who prescribes your diabetes medications what you should do the morning of your procedure.

Arrange for someone to take you home

You must have someone 18 years or older take you home after your procedure. Please call one of the agencies below if you do not have someone who can do this. They will help find someone to take you home.

  • Partners in Care: 888-735-8913
  • Caring People: 877-227-4649
  • Prime Care: 212-944-0244
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1 Day Before Your Procedure

Call the doctor who scheduled your steroid injection if you have a temperature higher than 100.5° F (38° C).

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The Day of Your Procedure

Do not eat or drink anything 3 hours before your procedure. This includes water, gum, and hard candy.

What to bring with you

  • A list of the medications you take at home
  • Medications for pain

Where to park

Parking at MSK is available in the garage on East 66th Street between York and First Avenues. To reach the garage, enter East 66th Street from York Avenue. The garage is located about a quarter of a block in from York Avenue, on the right-hand (north) side of the street. There is a pedestrian tunnel that you can walk through that connects the garage to the hospital. If you have questions about prices, call 212-639-2338.

There are also garages located on East 69th Street between First and Second Avenues, East 67th Street between York and First Avenues, and East 65th Street between First and Second Avenues.

Where to go

Your procedure will take place at 425 East 67th Street. This is a side entrance of the main MSK building. Take the A elevator to the 2nd floor.

What to expect

Once you arrive at the hospital, doctors, nurses, and other staff members will ask you to state and spell your name and date of birth many times. This is for your safety. Patients with the same or similar names may be having procedures on the same day.

After changing into a hospital gown and removing all necklaces, chains, and earrings, a pain doctor will review the procedure with you and answer your questions.

You will be helped onto the x-ray table and helped to lie on your stomach with a pillow under your belly. Using fluoroscopy, a type of x-ray, your doctor will locate where he or she will place the epidural to inject the steroid. When the correct location is found, a medication will be used to numb your skin. You may feel a small pinprick followed by a burning sensation. Your doctor will then insert the epidural in the area where he or she will inject the medication. Once your doctor is sure that the needle is correctly placed, he or she will inject the steroid. The needle will be removed and a bandage will be placed over the injection site.

This procedure takes 45 to 60 minutes to complete.

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After Your Procedure

At home

  • Your pain may increase up to 24 hours after your injection. This is normal. You may take an extra dose of your pain medication. If this pain continues longer than 48 hours, call your doctor.
  • It may take at least 3 days before you feel the full benefit of the steroid injection.
  • Do not drink alcoholic beverages for 24 hours after your procedure.
  • Take your pain medication as prescribed.
  • You can remove the bandage from you injection site 24 hours after your procedure.
  • You can shower 24 hours after your procedure.
  • Do not drive or do any other task where you need to be alert for 24 hours after your procedure.

Side effects

Some patients develop side effects from treatment. The type and how severe they are depend on many factors. The most common side effects after the steroid injection are:

  • Headaches
  • Temporary weakness, numbness, or tingling in your arms and legs
  • Some soreness at your injection site
  • A feeling of fullness in your back
  • Sleeplessness
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Call Your Doctor or Nurse if You Have

  • A temperature of 100.5° F (38.0° C) or higher
  • Pain that gets worse after 48 hours or changes locations
  • Shooting, burning or tightness in your back or legs
  • Leakage, redness, or swelling at the site where you got the steroid injection
  • Any unexplained or unexpected problems
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