What are the risks of epidural injections for back pain?

Epidural injections usually include a combination of corticosteroids and a numbing medicine in the family of Novocain. The needle is inserted into the space just outside the spinal cord (called the epidural space). These injections are most commonly recommended to treat:

• Osteoarthritis (or degenerative joint disease)
• Disc disease
• Spinal stenosis (a narrowing of the space where the spinal cord resides)

As with any other treatment, epidural injections are not risk-free. The most common side effects include:

• Discomfort or numbness during the injection
• Headache, nausea and vomiting
• Infection
• Bleeding along the path of the needle
• Nerve damage

Because of these risks, epidural injections are usually offered only occasionally (for example, a few times a year) and only for conditions in which improvement can be reasonably expected (such as those listed above). In addition, epidural injections are typically offered when other, less-invasive treatments (such as pain medications and physical therapy) are not effective.

Doctors performing these injections usually use a type of X-ray to confirm the proper location of the needle prior to injection. This helps limit complications. Fortunately, serious complications or side effects, such as infection or nerve damage, are quite rare.