What is an Epidural Cortisol Injection?

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  • Written By: Sandra Koehler
  • Edited By: C. Wilborn
  • Last Modified Date: 13 September 2019
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An epidural cortisol injection is a treatment option to help manage symptoms brought on when a nerve becomes irritated. This shot, a man-made combination of cortisone and an anesthetic, was created to mimic the natural stress response steroid secreted from the adrenal gland. Injected into the area of irritation, it aids in reducing inflammation and decreasing pain.

To prevent inflammation and aid in restoring the body's internal stability during stressful conditions, the body releases cortisol into the blood stream. It is a temporary reaction meant to be short in duration. Since it is released into the blood, prolonged cortisol secretion can affect the body's ability to maintain a stable internal environment.

The artificial version of this steroid, administered by an epidural cortisol injection, was created to be given directly into the area of irritation. This aids in the management of local symptoms without it traveling through the blood stream. Avoiding the blood means the concentration of the cortisol can be stronger. The addition of a local an anesthetic, such as lidocaine, aids in the reduction of pain symptoms.

The anti-inflammatory medication of an epidural cortisol injection is pushed into epidural space through a needle. This space is the area surrounding the spinal cord inside the vertebrae or spinal bones. Inside this canal-like area, the nerves attach to the spinal cord. Attacking nerve irritation and inflammation in the epidural space can be an effective means to lessen pain.


In addition to diminishing inflammation, an epidural cortisol injection can reduce related symptoms such as local or radiating pain traveling through the length of the nerve. It can also decrease the burning or tingling often associated with nerve irritation. By lessening these problems, it also aids in preventing limitations such as muscle weakness.

Lasting several weeks to several months, the benefits of an epidural cortisol injection are temporary but continue longer than the naturally produced steroid. Often, an injection every few months is necessary for pain and inflammation management. Since it is not put directly into the blood, the medication will not usually affect the body's blood sugar or immunity long term as can be experienced with a chronic secretion of natural cortisol.

Side effects of an epidural cortisol infection can include a temporary rise in blood sugar and irritation at the site of the needle entrance. Bleeding issues are uncommon but can occur if there are blood-related health conditions present. Occasionally, the needle pierces the protective covering of the epidural space. Called a dural tear, this break in the membrane can cause the fluid inside to seep out, triggering severe headaches which may require a blood patch to halt the leak.


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