How Long Does an Epidural Steroid Injection Take to Work for Sciatica?
If you have an epidural steroid injection (ESI) scheduled to calm sciatica, the question on your mind is probably simple: when will it actually help? Most people start to feel relief within two to seven days, with fuller benefit by about two weeks — though the timing is different for everyone. This guide walks through the real ESI timeline for sciatica: what happens in the first hours, when the steroid takes over, how long relief tends to last, and what to do if it doesn’t help.
Key takeaways
- Relief usually begins 2–7 days after the injection, with fuller benefit by about 2 weeks.
- The numbing medicine can give a few hours of early relief that then wears off — that is normal.
- Relief often lasts several weeks to a few months, and sometimes longer.
- Pain can briefly flare for 2–3 days first. New leg weakness or bladder changes need urgent care.
On this page
- How long does an epidural steroid injection take to work for sciatica?
- Why doesn’t the injection work right away?
- How long does the relief last?
- What is the success rate for sciatica?
- What if the epidural injection doesn’t work?
- Can sciatica get worse after the injection?
- How painful is the injection itself?
- What can you do to help it work?
- Frequently asked questions
How long does an epidural steroid injection take to work for sciatica?
Most epidural steroid injections start working within two to seven days, according to Cleveland Clinic. Some people notice a change in 24 to 72 hours; others need up to about two weeks for the fuller effect. The steroid needs time to lower the inflammation pressing on your sciatic nerve, so relief builds gradually rather than switching on all at once.
Epidural steroid injections start working within two to seven days, and pain relief can last from several days to a few months or longer (Cleveland Clinic, 2025).
Here is a rough picture of what patients often notice, and when:
| When | What you may feel |
|---|---|
| First few hours | Possible early relief or numbness from the anesthetic, which then wears off |
| Days 1–3 | Mild soreness at the site; pain may briefly get worse before it improves |
| Days 2–7 | The steroid starts to take effect and inflammation begins to settle |
| About 2 weeks | Fuller benefit for people who respond to the injection |
Why doesn’t the injection work right away?
An ESI usually contains two medicines: a local anesthetic and a steroid. The anesthetic can numb the area for a few hours, so you might feel good right after the procedure — then that early relief fades. The steroid, which lowers the inflammation around the nerve, takes a few days to build up. So a gap between first-day relief and lasting relief is expected, not a sign that the injection failed.
How long does the relief last?
Relief from an ESI for sciatica often lasts several weeks to a few months, and sometimes longer. Cleveland Clinic notes that lumbar (low-back) injections most often give relief lasting three months or more, though some people get less or none at all. Because the effect is temporary, most doctors limit patients to two or three injections per year.
Lumbar epidural steroid injections most often lead to temporary pain relief lasting three months or more, though some people experience less or no relief. Most providers limit patients to two or three injections per year (Cleveland Clinic, 2025).
What is the success rate for sciatica?
There is no single success rate. Results depend on what is causing your sciatica, how compressed the nerve is, and your overall health. Many people get meaningful, temporary relief; some get little or none. In one 2025 study of transforaminal epidural injections for lumbar radicular pain — the medical term for sciatica — average pain scores dropped from about 7 out of 10 to 2 out of 10 at four weeks, and most patients reported being satisfied. That is one study, though, not a promise for every case.
In a 2025 study of transforaminal epidural injections for lumbar radicular pain (sciatica), mean pain scores fell from 7.0 to 1.9 at four weeks and about 88% of patients reported satisfaction — while noting results vary between individuals (study in the NIH National Library of Medicine, 2025).
What if the epidural injection doesn’t work?
If a first ESI doesn’t help, that doesn’t mean you are out of options. Sometimes a second injection works when the first didn’t. If injections aren’t giving lasting relief, your doctor may look at other minimally invasive treatments — such as radiofrequency ablation — or take another look at the diagnosis. Empire follows a step-and-ladder approach: start with the least invasive option that can solve the problem, and only move up if it doesn’t. Major surgery is a last resort, not a first offer.
Can sciatica get worse after the injection?
A short-term flare is common. Cleveland Clinic notes your pain may get worse for two to three days after an ESI before it starts to improve. Mild soreness or bruising at the injection site is also normal and usually fades within a day or two. This temporary bump is different from a warning sign — see the red-flag box below for symptoms that need prompt attention.
How painful is the injection itself?
Most people tolerate an ESI well. The skin is numbed first, so you will usually feel pressure more than sharp pain during the procedure, which often takes under 30 minutes. Some soreness afterward is normal. If you feel anxious about it, tell your care team — they can walk you through each step and answer your questions before you start.
What can you do to help it work?
You can help an ESI do its job. Take it easy the day of the procedure, then ease back into gentle activity. The relief window is a good time for physical therapy, which treats the underlying cause of the sciatica rather than only the symptoms. For sleeping, many people are more comfortable on their back with a pillow under the knees, or on their side with a pillow between the knees.
When to seek care right away
Get medical care promptly if, after an ESI, you have new or worsening leg weakness, numbness in the groin or inner thighs, loss of bladder or bowel control, a fever with severe back pain, or a severe headache that worsens when you sit or stand up. These problems are uncommon, but they need prompt evaluation.
Frequently asked questions
How long does an epidural steroid injection take to work for sciatica?
Most start working within two to seven days. Some people feel a change in 24 to 72 hours, while others need up to about two weeks for the fuller effect, because the steroid lowers nerve inflammation gradually.
How long does the relief last?
Relief often lasts several weeks to a few months, and sometimes longer. Lumbar injections most often give three months or more of relief. Most doctors limit patients to two or three injections per year.
What is the success rate of epidural steroid injections for sciatica?
It varies with the cause and severity of the nerve compression. Many people get meaningful, temporary relief; some get little or none. An ESI eases symptoms so you can move and do physical therapy — it calms inflammation for a period of time rather than repairing the underlying cause.
What’s next if the epidural injection doesn’t work?
Options include a repeat injection, other minimally invasive treatments such as radiofrequency ablation, or a fresh look at the diagnosis. Your pain specialist can help you decide the next step based on your response and imaging.
Can sciatica get worse after the injection?
A brief flare for two to three days can happen before the injection starts to help, and mild soreness at the site is normal. New leg weakness or loss of bladder or bowel control is not — seek care right away if that happens.
What is the best position to sleep after an epidural steroid injection?
Many people are most comfortable on their back with a pillow under the knees, or on their side with a pillow between the knees. Take it easy and avoid strenuous activity for the rest of the day.
Medically authored by Dr. John Akhnoukh, MD — a board-certified anesthesiologist and interventional pain management physician at Empire Minimally Invasive Spine & Pain. Dr. Akhnoukh completed a pain medicine fellowship across New York-Presbyterian Hospital, Memorial Sloan Kettering, and Hospital for Special Surgery, and focuses on image-guided spine injections. His ongoing research includes work on improving lumbar epidural injections for spinal stenosis.
Dealing with sciatica in New York or New Jersey?
Empire’s interventional pain specialists offer image-guided epidural steroid injections and a full range of minimally invasive options for sciatica and back pain across Long Island, NY and northern NJ, including Plainview and Clifton. Schedule a consultation to talk through whether an ESI is right for you.
New York: 516-229-1443 | New Jersey: 732-630-7246
Dr. John Akhnoukh
Articles: 6
Medicare, Workers Comp,
No Fault & Others.
We accept most major insurance plans across our New York and New Jersey offices. Select your state to see accepted plans.
Accepted at our New York Locations
Workers' Compensation
No-Fault (NY & NJ)
Lien Cases
Medicare
Empire BCBS
BCBS / Anthem
Cigna
Aetna
Empire NYSHIP
Oxford (PPO)
United Health Care
GHI / Emblem Health
Humana (PPO)
Magnacare (PPO)
Northwell Direct
1199 SEIU
Self Pay
Accepted at our New Jersey Locations
No-Fault (NJ)
Lien Cases
Horizon BCBS
Empire NYSHIP
BCBS / Anthem (PPO)
Cigna
Aetna (PPO)
GHI / Emblem (PPO)
Port Authority UHC
Verizon Plan
Carpenter & Trade Unions
Self Pay
Medicare and Medicaid are not accepted at our New Jersey locations. Not sure about your plan? Call us and we'll verify before your visit.
Not sure about your plan?
Call Us — 516-229-1443
Verify Your Coverage for FREE
Enter your information and our team will confirm your benefits before your visit.
✓ HIPAA Compliant
✓ No Obligation
✓ Same-Day Response
Your information is encrypted and secure. By submitting, you consent to receive communications regarding your appointment. You may opt out at any time.
Meet Our Pain Management & Orthopedic Specialists
Dr. Monica Misak
Interventional Pain Specialist
Dr. James Yu, D.O.
Board Certified Anesthesiologist
Board Certified Interventional
Pain Management Physician
Dylan J. O'Rourke
Certified Physician Assistant
Pain Conditions Affecting Daily Life
Improve your quality of life with our comprehensive approach to pain management
We are dedicated to finding individualized treatment options tailored to fit your needs. Our team is dedicated to helping you lead a productive and active life, free from pain and disruption.
We use an integrative approach to conduct a comprehensive evaluation and assess your condition.
Physical examination and review of your medical history. We assess the cause of your pain, determine its severity and duration, and help you develop an individualized treatment plan.
We provide a range of treatments and procedures to address your chronic pain. These include nerve blocks, injections, physical therapy, implantable therapies and more. We also offer health education to help you better manage your condition.