Epidurals are a common procedure to provide pain relief or a lack of feeling for labor and childbirth, certain surgeries and certain causes of chronic pain. An epidural is generally a very safe procedure, but there are some risks and possible side effects.
An epidural is a procedure that involves injecting a medication — either an anesthetic or a steroid — into the space around your spinal nerves known as the epidural space. The goal of an epidural procedure is to provide pain relief (analgesia) or a complete lack of feeling (anesthesia) for one region of your body, such as your legs or belly.
An epidural is commonly called the following terms:
Cleveland Clinic is a non-profit academic medical center. Advertising on our site helps support our mission. We do not endorse non-Cleveland Clinic products or services. Policy
An epidural anesthesia injection works by injecting an anesthetic into the epidural space around your spine so that it can stop pain signals from traveling from your spine to your brain. The epidural space is filled with fluid and surrounds your spinal cord. Think of it as a liquid sleeve around your spinal cord.
Your spinal cord acts like a highway that connects the nerves located all over your body to your brain. When you get injured, for example, the nerve in that area of your body sends a pain signal that travels through your spinal cord to your brain and back. An epidural anesthetic temporarily numbs the spinal nerves, which then blocks pain signals in a certain region of your body depending on where along your spine your provider injected the epidural.
Epidural anesthesia can provide temporary pain relief or a temporary total lack of feeling. The following factors contribute to how much feeling you temporarily lose from an epidural:
An epidural steroid injection (ESI) works slightly differently and is used for chronic pain management. Instead of anesthetic medication, your provider injects a steroid or corticosteroid medication into the epidural space around your spine. Instead of blocking pain or feeling in a region of your body, the steroid coats the irritated nerve(s) that are causing you pain and works to reduce swelling. The steroid allows the nerve(s) time to heal. Epidural steroid injections can lead to temporary, long-term or permanent pain relief.
An anesthesiologist or certified registered nurse anesthetist usually performs an epidural procedure. Anesthesiologists have special training in the field of anesthesiology, which is a medical specialty that involves the care of people before, during and after their surgery or procedure. Anesthesiology covers anesthesia, pain medicine, intensive care medicine and critical emergency medicine.
Healthcare providers of other specialties, such as neurology, may also perform an epidural. Again, they’re specially trained to properly and safely perform an epidural procedure.
For epidural procedures that use a catheter, a supporting healthcare provider is usually present to help as needed.
Analgesia is pain relief without losing consciousness (going to sleep) and without complete loss of feeling or movement. Anesthesiologists use epidural analgesia for people who are in labor and are delivering a baby. They inject the epidural into your lower back to provide pain relief for the lower part of your body due to contractions and childbirth.
Anesthesia is the loss of physical sensation with or without loss of consciousness. Epidural anesthesia itself won’t cause a loss of consciousness, but if you’re having a certain kind of surgery, your anesthesiologist may give you epidural anesthesia so you don’t feel any pain or don’t move during the surgery and a different medication to make you go to sleep (lose consciousness).
Your healthcare provider may recommend an epidural procedure for the following situations:
There are different variations of epidurals based on certain factors. This section will explain different kinds of epidurals grouped into the following categories:
There are a few ways your healthcare provider can deliver medication with an epidural, including:
There are two general kinds of epidurals that you may choose during labor and childbirth. These include:
An epidural steroid injection (ESI) involves an injection of a steroid or corticosteroid into your epidural space. It can help relieve neck, arm, back and leg pain caused by inflamed spinal nerves due to certain conditions or injuries. Pain relief from an ESI may last for several days or even years.
People who have pain in their neck, arm, lower back or leg due to the following conditions may benefit from epidural steroid injections:
Epidurals are a common procedure. An epidural is the most popular method of pain relief during labor and childbirth. More than 50% of people who give birth at a hospital choose to receive epidural analgesia. Epidural steroid injections (ESI) are one of the most commonly performed pain relief procedures.
Due to certain medical conditions, not everyone can have an epidural. Because of this, it’s important to talk to your healthcare provider about your medical history and any questions you have. If you have any of the following conditions, you may not be able to get an epidural:
If you’re unable to undergo an epidural procedure, your healthcare provider may recommend another type of pain relief or anesthesia for you, or they may have you wait until a better time to have your surgery, if possible.
Your healthcare provider will give you specific instructions about what you need to do to prepare for your epidural. Be sure to follow their instructions. Your provider may:
Questions that may be helpful to ask your healthcare provider before you get an epidural include:
This section will explain the general procedure for two kinds of epidurals: epidurals that use a catheter and epidural steroid injections.
Single-injection epidurals are similar in procedure to epidurals that use a catheter except there’s no catheter placement. Your provider will inject one dose of medication when they insert the needle into your epidural space.
The steps involved in an epidural procedure that uses a catheter include:
Epidural steroid injections are often used to manage or treat chronic pain. Depending on what’s causing your pain, your healthcare provider will inject the epidural somewhere along your spine. Here are the general steps of an epidural steroid injection procedure:
You’ll likely experience a minor pinch when your provider injects the local anesthetic to numb the area before the epidural procedure.
You may feel pressure, tingling, a burning sensation or momentary shooting pain when your provider injects the epidural. Or you may not feel anything. If you have any discomfort during the injection, it usually disappears once the injection is finished.
If you feel intense sharp pain during or after your epidural procedure, tell your provider immediately.
If you’ve had an epidural with anesthetic medication, it’ll take 20 to 30 minutes for your pain relief and/or loss of feeling to take full effect.
Epidural steroid injections start working within two to seven days, and the pain relief can last several days or longer.
There are different advantages of getting an epidural depending on why you’re getting it.
The advantages of getting epidural analgesia during labor and childbirth include:
The advantages of epidural anesthesia injections for surgery include:
The advantages of epidural steroid injections include:
Epidurals are usually safe, but there are risks of certain side effects and complications. Although rare, risks and complications that apply to all types of epidural procedures include:
Disadvantages and risks that apply to epidural analgesia for labor and delivery specifically include:
Risks and complications that apply to epidural steroid injections specifically include:
There’s a common belief that getting an epidural will lead to back pain, but it’s very rare for an epidural to cause long-term or chronic back problems.
It’s normal to experience temporary back pain or tenderness at the site of your epidural. This usually goes away within a few days.
This belief likely stems from the fact that many people who go through childbirth experience back pain after labor and delivery — whether they’ve had an epidural or not. This is because the bones and ligaments in your pelvis are shifting back into their original positions from before your pregnancy, which can cause back pain and discomfort.
While it’s very rare, having an epidural procedure can lead to some long-term complications, including:
How long an epidural lasts depends on what kind of epidural you got and what kind of medicine your healthcare provider injected. Your provider will let you know what to expect. In general, here’s how long certain types of epidurals last:
If you’ve had an epidural, do not drive, operate machinery or drink alcohol for at least 24 hours after. Your healthcare provider will give you specific instructions about when you can return to your normal activities depending on your type of epidural and your situation. Be sure to follow them.
If you experience any of the following symptoms after you’ve returned home from your epidural procedure, be sure to contact your healthcare provider or go to the nearest hospital as soon as possible:
An epidural and a spinal block both provide pain relief through an injection in the area around your spine. The differences are the placement and the effect.
With an epidural, your healthcare provider injects anesthesia into the epidural space around your spinal nerves. With a spinal block, your provider injects the anesthesia into the dural sac around your spinal nerves that contains cerebrospinal fluid. This placement of a spinal block injection means that it gives immediate relief. Epidural injections usually take 20 to 30 minutes before you feel the full effect of pain relief or lack of feeling.
If you get an epidural for labor and childbirth, you may experience the following side effects, which aren’t very common, after delivery:
You will likely have a small bruise and some tenderness at the site of the epidural after delivery. This should get better in one to two days.
A note from Cleveland Clinic
Epidurals are a common, effective and generally safe procedure to deliver quick pain relief and/or a temporary lack of feeling. If you’re feeling anxious about the possibility of receiving an epidural, don’t be afraid to ask your healthcare provider about it and the procedure. They can answer any questions you may have.
Last reviewed by a Cleveland Clinic medical professional on 10/14/2021.
Learn more about our editorial process.