If you suffer from shooting pain down your leg, you may be interested in learning about cortisone injections for back pain. Many people deal with low back pain, sciatica specifically, which causes pain along the path of the sciatic nerve and turn to cortisone shots for pain relief.
For a detailed look at what cortisone injections are, please see my post here.
As for this post, I would like to take a look at what is involved with this procedure and what you can expect. If you are one of the millions of people who suffer from sciatica, please continue reading below and see if a cortisone injection might be worth a shot.
Cortisone injections are one of the non-surgical options available to treat sciatica. You may be dealing with sciatica for the first time, or have chronic pain. Either way, you may have a lot of questions and are exploring different treatment options. As a chronic sufferer myself, I have tried cortisone injections.
Working with your doctor
The first thing, of course, is to work with your healthcare provider (doctor or chiropractor for example) and determine what the source of your pain is. Sciatica itself is not a diagnosis, but a symptom of a larger spinal issue. A common problem is a herniated disc which is compressing the nerve and causing pain.
If you and your healthcare provider determine that injections might be a treatment option for you, here is what you can expect.
How to prepare
You will receive instructions from your doctor for any changes to your usual routine, as far as food, or beverages are concerned before your injections. This is typically appropriate when sedation is used.
Sedation is available, but most people don’t need it
If you chose to be sedated, your doctor would guide you as to how to prepare for that, meaning no food or drink before the procedure, etc. Sedation is usually used for anxiety, to keep you calm. My experience has been that the process is not necessarily painful, but more just somewhat uncomfortable.
It’s a little freaky if you think about what they are doing, which is why it is nice if you can keep your mind on something else. The fact that a needle is going into your spinal area can be a little off-putting for some.
Of course, it depends on your tolerance for needles and your experience. Maybe you have been through this before, and it’s not a big deal.
I have been a little squirmy, and it’s just because I can’t keep my mind otherwise occupied. Everyone is different. For me, it’s more just uncomfortable, and the pressure of the needle is what I feel. Even though you may not feel the pain of the needle, you can feel some pressure.
So, the doctor will walk you through the process if you are going to be sedated.
You should wear loose, comfortable clothing and leave any jewelry at home. 
Be prepared to wear a gown, at least which was my experience. This way the doctor will not have to contest with your clothing during the procedure.
Typically a patient will face down, with a pillow under their stomach to allow more room for the needle. Yes, there are needles involved in getting a shot. If laying on your stomach is painful, the doctor may have you upright, or lay down on your side in the fetal position.
The doctor will give you a small shot to numb the skin where the injection will be administered. Yes, the procedure involves giving you a little shot before the doctor pulls out the big guns.
How are the injections administered?
The doctor will use x-ray equipment and contrast (x-ray dye) to assist them in making sure the needle is placed precisely where they want it to go. The x-ray equipment allows the doctor to see inside and guide them to the right spot.
The dye that they use goes in before the actual cortisone shot, and this gives the doctor the ability to see if the medication will go to the right place.
So, they put a needle in your back to make sure everything is going just exactly where they want it, and kind of test that with the dye, which shows up on the x-ray. Then, the doctor is able to inject the medication as precisely as possible to the damaged area.
After the procedure
The recovery process is pretty straightforward. The doctor will keep you in the office for a while, 20-30 minutes after the injection to see how you will react. If all is good, they will let you go.
Usually, it’s a good idea to lay low for the rest of the day, and then you can hopefully go about your regular routine the next day.
You may want to have someone to drive you home. My first experience was not bad, and I didn’t need a driver, but I sure could have used one the second time.
My right foot was numb to the point that I could not move it from the gas to the brake pedal without using my arms to lift my leg. I don’t know how I was ever released from the doctor’s office in that condition.
You just don’t know how your body will react, everyone is different.
How often can you get a shot?
I have seen some conflicting information on this topic, but the general consensus is no more than three injections per year. This Mayo Clinic article talks about the limit is in place as the steroid mixture can affect your hormone balances.
Does it hurt?
Well, that depends on you. It’s a pretty routine procedure, and you can be given a sedative, but most people don’t need that. The pain is pretty mild.
Depending on the severity of the inflammation, you may experience some additional pain with the injection since the medication is taking up extra space in the area where it is already crowded with inflammatory agents from your body.
You can feel more pain until the medicine starts to work, due to increased bleeding or swelling in the area where the injection is performed. Some people do experience more pain after the dose since the steroid mixture itself is taking up space.
Other side effects may include nerve injury, headaches, a localized increase in pain. 
How long do they last?
Again, this is dependent on the person, for some people it can last a few weeks, up to a year. Everyone is different.
My experience has been that I felt some immediate relief, which just happened to be the local anesthetic that is part of the medication mixture.
This wore off fairly soon, like within an hour, and then I was right back to where I was before. I was so excited until the doctor told me to temper my enthusiasm, such a downer :).
How long before it works?
I sound like a broken record, but once again, this depends on how your body will react to the medication. Some people will notice pain relief relatively quickly, within a few days, others may take a few weeks to kick in. Some people will receive no pain relief at all.
Is this a permanent fix?
This is definitely not a permanent fix. The goal is to reduce pain and inflammation so that you can work at fixing the root cause of the pain, through such methods as chiropractic care, physical therapy, or exercise.
Contraindications are medical conditions that would not make you a good candidate for the epidural steroid injection procedure.
Conditions may include pre-existing conditions, any allergies you may have to the medications being used (which are rare), or medication you take that may react with the steroid mixture.
Conclusion: Cortisone injections for back pain
As with many treatments for lower back pain, the benefit of the injection will vary from person to person. Some people will receive pain relief quickly, while other people, like myself, receive no pain relief at all.
One thing that has worked well for me in the past is using an inversion table.
It is essential to work with your doctor to see if you are a candidate for this procedure and he or she will walk you through the whole process.
The thought of needles going into your spine can be a little unnerving if you have not been through this before. It’s not a big deal, but I was nervous the first time I had it done.
I hope you have a better idea what is involved with cortisone injections for back pain.
If you have any questions or comments, please leave them below, and I will do my best to answer as soon as I can.
Thanks for taking some time out of your day!