A lumbar epidural steroid injection is a common procedure to treat low back pain and sciatica caused by inflammation in the spine. The injection delivers corticosteroid medication directly into the epidural space around the nerve roots in the low back. This helps reduce inflammation and pressure on the spinal nerves, providing pain relief.
While relatively safe, a lumbar epidural does involve inserting a needle into the spine, so it’s normal to have some restrictions on activity afterward to allow the procedure site to heal. Typical restrictions after a lumbar epidural steroid injection aim to limit strain on the low back and prevent complications like bleeding or infection at the injection site. Restrictions are usually only needed for the first 1-2 days after the injection.
Common Restrictions After a Lumbar Epidural Steroid Injection
Here are some of the most common restrictions following a lumbar epidural steroid injection:
No strenuous physical activity
Doctors typically recommend avoiding strenuous physical activity, exercise, and sports for the first 1-2 days after a lumbar epidural injection. This includes things like heavy lifting, bending and twisting movements, running, weight lifting, contact sports, etc. Gentle walking is usually ok. The goal is to prevent straining the low back while the injection site heals.
No driving for 24 hours
You should not drive for 24 hours after a lumbar epidural steroid injection. The numbing medication given during the procedure can make it difficult to control your leg muscles for operating the pedals. The sedative medication can also impair your reflexes. This driving restriction is for safety reasons.
Take it easy and rest
While complete bed rest is not necessary, doctors recommend taking it easy and getting some rest for 1-2 days after a lumbar epidural. This allows the corticosteroid medication time to start working at reducing inflammation. Be sure to change positions or get up and move around at least hourly when resting to prevent stiffness.
Avoid hot baths/showers for 24 hours
Hot baths or showers can increase inflammation and bleeding at the injection site, so they are not recommended for 24 hours post-procedure. Lukewarm baths or showers are fine. Avoid heating pads or ice packs on the low back as well during the first day.
Do not massage the injection area
Massaging or applying pressure over the injection site could worsen inflammation or even cause bleeding if done too soon after the procedure. Leave the injection area alone for the first day or two while it starts healing.
Tips for a Comfortable Recovery After Lumbar Epidural Steroid Injection
Here are some tips to help make the recovery period as comfortable as possible after a lumbar epidural injection:
Use cold therapy
While heating should be avoided, using cold therapy can help minimize swelling and discomfort after the injection. Try wrapping an ice pack or bag of frozen vegetables in a thin towel and placing it on your low back for up to 20 minutes a few times per day. Never place ice directly on the skin.
Take over-the-counter pain medication as needed
Your doctor may prescribe prescription pain medication, or instruct you to take over-the-counter options like acetaminophen (Tylenol) or an NSAID like ibuprofen (Advil, Motrin) for post-injection soreness. Follow dosage instructions carefully and do not exceed maximum daily amounts.
Adjust your position frequently when resting
Avoid staying in one position too long while resting. Get up and walk around for a few minutes at least hourly. Switch between lying down, sitting upright, and reclining. Use extra pillows as needed for comfort and to take pressure off your back.
Stay hydrated
Drink plenty of fluids as you recover from the epidural injection to help flush out the injected steroids and remaining anesthetic/sedative medications. Water, herbal tea, broths, and electrolyte drinks are ideal choices.
Watch for concerning symptoms
Rarely, complications can occur after an epidural like infection, bleeding or nerve damage. Contact your doctor if you have symptoms like worsening back/leg pain, limb weakness, fever, numbness or bladder problems. Most recover without issues.
When Can You Return to Normal Activity After Lumbar Epidural Injection?
Here’s a general timeline for returning to normal activities after lumbar epidural steroid injection:
After 24 hours:
– Showering and bathing normally are ok
– Driving is ok in most cases if not impaired
– Gentle back stretches and light activity are ok
After 48 hours:
– Most restrictions are lifted
– Normal physical activity and exercise can resume gradually
– Still avoid heavy lifting and strenuous activity for at least a few more days
After 1 week:
– You should be able to resume full normal activities
– Strength training and heavy lifting are ok
– Contact sports may still be discouraged for 2 more weeks
After 2 weeks:
– All activity restrictions are lifted
– Ok to return to sports and heavy physical labor jobs
– Follow up with your doctor about the results of the injection
Always discuss with your doctor when it is safe to return to your normal work and activity routines based on your response to the injection. Most patients can resume full activity within 1-2 weeks with no restrictions.
Conclusion
Typical restrictions in the first 1-2 days after lumbar epidural steroid injection include avoiding strenuous physical activity, no driving for 24 hours, taking it easy and resting, avoiding hot showers/baths, and not massaging the injection site. This allows time for the area to start healing and avoids complications. Within 1 week, most patients can return to normal daily activities. While short-term restrictions are needed, an epidural steroid injection can provide significant pain relief with minimal downtime for many patients with low back and leg pain caused by spinal inflammation. Be sure to discuss your expected recovery with your doctor.
| Activity | 24 Hours After Injection | 48 Hours After Injection | 1 Week After Injection |
|---|---|---|---|
| Strenuous exercise/sports | Avoid | Avoid | Gradual return ok |
| Heavy lifting | Avoid | Avoid | Gradual return ok |
| Driving | No | Ok if not impaired | Yes |
| Light activity | Gentle walking ok | Yes | Yes |
| Bathing | Lukewarm only | Yes | Yes |
| Massaging injection site | No | No | Ok after 48 hours |