It varies. Some patients get relief that lasts months or even permanently for that episode (especially if combined with fixing the root cause and therapy). Others might feel great for a while but then symptoms slowly return after a few weeks. Generally, the goal is to get several weeks of relief at least, during which time you can heal and strengthen. If pain returns, we can consider another injection. 

We usually don’t do more than 3 injections in a 6-12 month period focused on one area, due to diminishing returns and steroid dose limits. Every individual responds differently. We’ve seen patients break a pain cycle with one shot and never need another, and others who come periodically for maintenance injections.

Not directly – it doesn’t make a big disc herniation disappear (surgery or time does that), but it reduces the inflammation and pain so that your body can often mend on its own. Discs can shrink over time. If you can stay active and do therapy because you’re not in severe pain, that helps recovery. So, think of it as symptom control and a window of opportunity for natural healing. In some cases, if the underlying structural issue is severe (huge disc fragment, severe stenosis), an injection may only be a temporary bridge and surgery might still be needed. But many times it’s enough to avoid surgery.

We do our best to minimize discomfort. The initial numbing injection stings for a few seconds. After that, you feel pressure rather than sharp pain. If you feel anything sharp or a jolt during, let us know – we adjust the needle or give more numbing. Most patients tolerate it well and say it’s not as bad as they expected, often rating it mild to moderate discomfort, not severe. If you’re especially anxious, mild sedation can be arranged, but then you’d need someone to drive you and a bit longer recovery. Typically, it’s over so fast that patients do fine with just local anesthetic.

If one injection gives partial relief, we might do a second one in 2 weeks to compound the effect. If it gives no relief at all, we’d reexamine the diagnosis: maybe the pain isn’t from nerve inflammation (for example, could it be hip arthritis referring to the leg, etc.). Or maybe the level injected wasn’t the right one (rare if imaging correlates well, but sometimes multiple levels). We may try another at a neighboring level if clinically indicated. 

If after a couple attempts there’s no improvement, then ESIs are likely not the solution for your case, and we’d pivot to other treatments (different injection types, medications, or surgical consult depending on the issue). Our aim is to use the right tool for the job – we’ll reassess if needed.

No heavy exercise or strenuous activity on the same day – just rest. From the next day, you can gradually resume activities. We often tell patients to listen to their body – if you feel good, you can do more, but don’t overdo it immediately. Keep walking, do gentle movements, but avoid heavy lifting or twisting for a couple days as the medication settles in. 

If you are in physical therapy, we might have you skip a day or two after injection then continue. Most people can fully return to their normal routine by 24-48 hours post injection. You might feel so good you want to catch up on chores – still take it easy at first to avoid flaring things up. And, keep taking any prescribed medications unless directed otherwise.