Epidural injections are a targeted treatment for chronic spinal pain. By delivering anti-inflammatory medication into the epidural space around your spinal nerves, they help reduce swelling, ease nerve irritation, and relieve pressure that causes persistent back or leg pain.
This minimally invasive option is often used for conditions like herniated discs, spinal stenosis, or sciatica - especially when other treatments haven’t provided lasting relief.
What is an epidural?
An epidural is a form of pain relief delivered through an injection into the epidural space - the area around the spinal nerves in your lower back. The injection includes local anaesthetic and steroid treatment. It can provide chronic pain relief and reduce inflammation in your neck, back, arm and leg.
Epidurals can meet differing needs, whether for short-term relief or ongoing pain management. They are commonly used for:
- Labour and childbirth - easing pain during delivery or caesarean section
- Surgical procedures - as part of regional anaesthesia
- Post-operative pain relief - supporting comfort after surgery
- Back pain treatment - for conditions like herniated discs
- Chronic pain management - especially in your lower back, pelvis, or legs.
Epidurals for chronic pain relief
An epidural injection for chronic pain relief is an outpatient procedure. It treats common causes of back problems including injuries, osteoarthritis, inflammatory arthritis, herniated disc and spinal stenosis. These compress your spinal nerves and cause back pain that may extend to the other parts of your body such as your neck and legs.
How does an epidural work?
Epidurals work by delivering medication into the epidural space - the area surrounding the spinal nerves in your lower back. Depending on the type of epidural, the medication either blocks pain signals or reduces inflammation around irritated nerves.
Epidural anaesthesia - is commonly used during surgery or labour. It blocks pain signals from travelling from your spinal nerves to your brain, safely and temporarily turning off nerve activity in the targeted area. Relief duration depends on the medication type and dose.
Epidural steroid injections - are most commonly used for chronic pain relief. They are a targeted, minimally invasive option that can offer significant relief for persistent nerve-related pain. These injections coat the irritated nerves causing pain, helping to reduce swelling and pressure. This can relieve symptoms related to conditions such as herniated discs, spinal stenosis, or sciatica.
Types of epidural injections
There are several ways epidural medication can be delivered:
- Single-injection epidural - a one-time injection of steroid medication into the epidural space. This is the most common method used for chronic pain management.
- Epidural with catheter - a small tube is placed into the epidural space to allow continuous or repeated doses of medication. This method is typically used for anaesthesia during surgery or labour.
- Patient-controlled epidural analgesia (PCEA) - a catheter remains in place after surgery, allowing patients to control when they receive pain relief using a handheld device. This is used for short-term post-operative pain management.
- Combined spinal-epidural (CSE) - a combination of spinal and epidural techniques, often used in labour to provide both rapid and sustained pain relief.
Your consultant will help determine the best approach based on your symptoms and medical history.
Preparing for an epidural
Your healthcare team will give you specific instructions based on the type of epidural you're having and the reason for your procedure. It's important that you follow these carefully to ensure your safety and comfort.
Here are some general steps to help you prepare:
- Discuss any concerns with your doctor, especially if you have questions about the procedure or past reactions to anaesthesia.
- Share your medication list, including any prescriptions, over-the-counter supplements, or blood thinners. You may need to pause certain medications before your epidural.
- Follow fasting instructions if advised. This may include avoiding food and drink for several hours beforehand.
- Arrange transport home, as you won’t be able to drive for 24 hours after the procedure.
- Wear comfortable clothing and avoid tight waistbands, especially if you're receiving an injection in your lower back.
How an epidural is given
Epidurals are administered by a specialist doctor called a consultant anaesthetist or a consultant pain specialist who is trained in pain management and spinal procedures. You’ll usually be awake during the procedure, though in some surgical cases it may be given under general anaesthetic.
What to expect during the procedure
The exact process depends on the type of epidural you’re receiving - whether it’s a single injection for chronic pain or a catheter-based epidural for surgery or labour.
In general:
- A drip (IV line) may be placed in your arm to provide fluids
- You’ll be asked to sit and lean forward, or lie on your side with your knees drawn up
- The consultant pain specialist will numb your skin with a local anaesthetic
- A needle is inserted into your epidural space near the spinal nerves, often under X-ray imaging guidance.
If you're receiving a single-injection epidural (commonly used for chronic pain), the medication is injected directly through the needle. The needle is then removed, and a dressing is placed over the site.
If you're receiving a catheter-based epidural, a fine plastic tube is threaded through the needle into the epidural space. The needle is then removed, leaving the catheter in place to deliver medication continuously or in repeated doses.
The epidural can be placed at different areas of your spine depending on where you need pain relief. You may feel mild pressure or discomfort during the procedure.
Pain relief typically begins within 20 to 30 minutes. While the medication is active, you may experience numbness or reduced strength in your lower body.
Recovering from an epidural steroid injection
Most people feel well enough to go home shortly after the procedure. You’ll need someone to drive you and ideally stay with you overnight, as you shouldn’t drive, drink alcohol, or operate machinery for 24 hours.
The injected area may feel numb for several hours. Among the effects after epidural injection, it’s common to experience temporary discomfort once the anaesthetic wears off. Pain may briefly increase before the steroid begins to take effect. This can take 3 to 7 days, with full relief often felt within 10 days. Over-the-counter painkillers can help manage discomfort during this time.
You should rest and avoid strenuous activity for the first 24 hours. Most people can walk within a few hours when the numbness fades and strength returns to your legs. After the first day, you can typically resume normal daily activities unless advised otherwise.
How long does an epidural last for chronic pain?
The extent of pain relief and how long it lasts varies from person to person. An epidural injection can reduce chronic pain for up to three months. The injection is usually given in conjunction with physiotherapy as part of a holistic back pain treatment. The epidural reduces your pain symptoms so that physiotherapy is more manageable and effective.
How many epidural steroid injections are safe in a lifetime?
It is thought that you can safely have epidurals throughout your lifetime for short-term pain management caused by a herniated disc or other spinal condition or injury. However, an epidural steroid injection does not repair the damage that is causing your pain. This means that pain is likely to keep reoccurring once the effects of the steroid wear off.
Physiotherapy may be recommended alongside your steroid injections to help strengthen the muscles that support your spine and reduce pressure on your spinal column. Physiotherapy exercises are often easier with reduced inflammation and pain after these injections.
Surgeons may recommend surgery for a longer-term treatment.
Usually, surgeons limit epidural steroid injections to just a few a year. This is because of possible side effects of the steroid including weakening of your spinal bones and nearby muscles.
Epidural side effects and risks
Epidurals are widely used and generally considered safe for pain management, whether for surgery, childbirth, or chronic pain relief. They are administered by consultant anaesthetists or consultant pain specialists trained to minimise risks and monitor your response throughout the procedure.
However, as with any medical treatment, there is a small chance of side effects or complications.
These may include:
- Low blood pressure, which can cause lightheadedness or nausea
- Headaches, especially if cerebrospinal fluid is accidentally affected (rare)
- Temporary loss of bladder control
- Itchy skin or feeling sick
- Bleeding or infection at the injection site
- Nerve irritation or damage, which is extremely rare
- Reactions to the anaesthetic or steroid medication.
Most epidural side effects are mild and short-lived. Serious complications are rare, and your healthcare team will monitor you closely before, during, and after the procedure to ensure your safety.
If you have any concerns or a history of reactions to anaesthesia or steroids, you should discuss these with your consultant beforehand.
What is the cost of an epidural?
The cost of an epidural steroid injection will depend on: the exact steroid drugs and anaesthetic; the reason and area for your procedure; and your Ramsay hospital of choice.
You will receive a formal quotation price for your steroid injection, after your consultation with one of our expert surgeons. This formal quote will be valid for 60 days. You can rest-assured that it includes unlimited aftercare.
We have a number of flexible ways to fund for your treatment. These include:
- 0% Payment Plans - allows you to spread the cost of your treatment across our flexible payment plans with fixed, monthly payments over a time period to suit you.
- Self-fund treatment - All-inclusive Total Care - a one-off payment at a pre-agreed price that covers all the treatment you need. Our Total care packages include your operating drugs.
- Use your insurance - We are partnered with the major insurance companies, Epidural steroid injections are generally covered by health insurance if medically recommended. You should obtain written confirmation from your insurance provider before starting your treatment.
Epidural Injections at Ramsay Health Care
Ramsay Health Care offers fast access to Consultant Pain Specialists and diagnostics to assess your back, legs and neck pain. Our consultants are highly skilled and frequently perform epidural steroid injections. They will provide you with the very best and safest care to relieve your pain.
Our hospitals are conveniently located across the UK and most have on-site parking.
We also have practised and proficient physiotherapists on hand who can advise on exercises to improve your strength, spinal mobility, and stability whilst you have the effects of the steroid.
Contact us today to speak to our friendly advisors to find out more about pain management treatments we offer, pricing and to book your initial appointment.
