Epidural: Types, Procedure, Side Effects and Recovery
Written and medically reviewed by Dr. Baraa Alnahhal, MD · Last reviewed: October 2026 · How we review
Quick Answer: What is an epidural?
An epidural is an injection into the space around the spinal nerves, used to numb pain or reduce nerve inflammation. Anesthetic epidurals relieve pain during labor and surgery within about 20 to 30 minutes, while steroid injections ease back pain for a few months. Serious side effects are rare. [1]
What the research says
Epidurals give stronger labor pain relief without raising the cesarean rate. A review of 40 trials involving more than 11,000 women found lower pain scores and more satisfaction than with opioid pain relief, and no difference in cesarean section rates (10,350 women) or long-term backache (814 women). (Anim-Somuah et al., Cochrane Database Syst Rev, 2018) [2]
Steroid injections give modest, short-term relief for sciatica. Across 17 studies, epidural steroid injections eased leg pain more than placebo injections at 6 weeks and 3 months, although the average gain fell below the level patients usually notice as meaningful; complication rates were low. (Verheijen et al., Eur Spine J, 2021) [3]
An accidental puncture of the spinal sac can have lasting effects. In a meta-analysis comparing 6,541 women who had an accidental dural puncture or post-puncture headache with 1,004,510 women whose procedures were uncomplicated, the complication was linked to about four times the risk of headache lasting 12 months or longer (RR 3.95). (Mims et al., J Clin Anesth, 2022) [4]
Key takeaways
An epidural delivers medicine into the epidural space, the area around the spinal nerves. [1]
There are two main types: epidural anesthesia, which numbs pain, and epidural steroid injections, which calm inflamed nerves. [1]
Anesthetic epidurals work in about 20 to 30 minutes. Steroid injections take a few days and can help for a few months. [1]
Avoid driving, operating machinery, and drinking alcohol for at least 24 hours afterward. [1]
Fever, loss of bladder or bowel control, lasting leg weakness, or a severe headache when upright need prompt medical attention. [1]
Epidural at a glance
Question | Short answer |
What is it? | An injection into the space around the spinal nerves [1] |
Main types | Epidural anesthesia and epidural steroid injection (ESI) [1] |
Main uses | Labor pain, surgery, pain after surgery, back pain from a herniated disk, chronic pain [1] |
Time to work | About 20–30 minutes (anesthetic); within a few days (steroid) [1] |
How long it lasts | A few hours (single anesthetic shot); a few months (steroid) [1] |
Is it safe? | Considered safe and effective; serious side effects are rare [1] |
After the procedure | No driving, machinery, or alcohol for at least 24 hours [1] |
What is an epidural used for?
An epidural is used to relieve pain or to numb part of the body for a procedure. [1]
Common uses include: [1]
Pain relief during labor and childbirth (see the three stages of labor)
Anesthesia before surgery
Pain control after surgery
Back pain from conditions such as a herniated disk
Long-term (chronic) pain
What are the two main types of epidurals?
The two main types of epidurals are epidural anesthesia and epidural steroid injections. [1] Both reach the same space around the spinal nerves, but they use different medicines and do different jobs.
Feature | Epidural anesthesia | Epidural steroid injection (ESI) |
What it does | Numbs feeling and pain by blocking pain signals from the spinal nerves to the brain [1] | Delivers a corticosteroid that reduces inflammation and pressure on irritated nerves [1] |
Typical use | Labor, surgery, pain after surgery [1] | Back pain from conditions like a herniated disk, chronic pain [1] |
Starts working | About 20–30 minutes [1] | Within a few days [1] |
How long relief lasts | Hours (longer with a catheter) [1] | A few months [1] |
For one specific injection approach, see our guide to the caudal epidural steroid injection.
How are epidurals given?
Epidurals are given as a single injection, through a thin tube (catheter) for repeated doses, through a patient-controlled pump, or combined with a spinal injection. [1] The method depends on why you need it and how long relief must last.
Method | How it works | Often used for |
Single injection | One dose of medicine, then the needle is removed [1] | Steroid injections for back pain [1] |
Catheter | A thin tube stays in place so medicine can be given again [1] | Labor and longer surgeries [1] |
Patient-controlled analgesia (PCA) | A handheld pump lets you give yourself pain medicine within set limits [1] | Pain after surgery [1] |
Combined spinal-epidural (CSE) | A spinal dose plus an epidural catheter [1] | Labor [1] |
A combined spinal-epidural usually leaves some feeling in the legs and allows some movement, but most people cannot walk fully while it is working. [1]
How do you prepare for an epidural?
Preparing for an epidural usually means fasting for several hours, adjusting some medicines, and arranging a ride home. [1] Your care team will give you instructions that fit your situation.
Fasting: You may be asked not to eat or drink for several hours beforehand. [1]
Medicines and supplements: You may need to stop some of them, especially blood thinners. [1] Related reading: factor Xa inhibitors and epidural hematoma.
Transport: Arrange for someone to drive you home. [1]
Never stop a prescribed medicine on your own. Ask the doctor who prescribed it first.
What happens during an epidural procedure?
During an epidural, a provider numbs your skin, then guides a needle into the epidural space and delivers the medicine, sometimes leaving a thin catheter in place. [1] The steps differ slightly between a single injection and a catheter epidural.
Single-injection epidural
You usually lie face down. [1]
A local anesthetic numbs the skin. [1]
The provider uses fluoroscopy, a type of real-time X-ray imaging, to guide the needle. [1]
The medicine is injected and the needle is removed. [1]
Catheter epidural
An IV line is placed. [1]
You lie on your side or sit up. [1]
The skin is numbed, and the needle is placed in the epidural space. [1]
A thin catheter is threaded through the needle, and the needle is removed. [1]
The catheter stays in place for hours or days until you no longer need the medicine, then it is taken out. [1]
What does an epidural feel like?
An epidural usually feels like a quick pinch from the numbing shot, followed by pressure. [1] Some people also notice tingling, a burning feeling, or a brief shooting pain during the injection, which usually fades. [1]
Tell your provider right away if you feel sharp, intense pain during the procedure. [1]
How long does an epidural take to work, and how long does it last?
An anesthetic epidural takes about 20 to 30 minutes to work, while a steroid injection starts working within a few days. [1]
Type | Starts working | How long it lasts |
Single-injection anesthetic | About 20–30 minutes [1] | A few hours [1] |
Catheter anesthetic | About 20–30 minutes [1] | Numbness lasts a few hours after the last dose [1] |
Epidural steroid injection | Within a few days [1] | Usually a few months; about 3–6 months for pain management [1] |
What is recovery like after an epidural?
Recovery after an epidural usually takes a day or two, with no driving, operating machinery, or drinking alcohol for at least 24 hours. [1]
First 24 hours: Do not drive, use machinery, or drink alcohol. [1]
First day or two: Some physical activity may need to be limited. [1]
First few days: Mild tenderness where the needle went in is normal and usually settles within days. [1]
Returning to normal: Follow your provider's advice on when to restart your usual activities. [1]
What are the benefits of an epidural?
The main benefits of an epidural are flexible timing, generally milder side effects than some other types of anesthesia, and, for steroid injections, a chance to get back to activities. [1]
Flexibility: An anesthetic epidural can often be started during labor. [1]
Milder side effects: Side effects are generally milder than with some other forms of anesthesia. [1] (Compare options in our anesthesia guide and nerve blocks guide.)
Steroid injections: Relief may help you return to daily activities and, for some people, avoid surgery. [1] This is often discussed for sciatica and spinal stenosis.
What are the risks and side effects of an epidural?
The risks of an epidural are rare and include bleeding or infection at the injection site, a spinal fluid leak, nerve damage, medicine reactions, and spinal cord injury. [1]
Risk | What it means |
Bleeding or infection | At the injection site; rare [1] |
Cerebrospinal fluid (CSF) leak | Very rare [1] (see CSF leak and spinal headache) |
Nerve damage | Rare; may lead to chronic pain [1] |
Reaction to the medicine | Rare [1] |
Spinal cord injury | Rare [1] |
Related reading: epidural blood patch.
Can an epidural cause long-term back pain?
Long-term back problems caused by an epidural are very rare. [1] Some tenderness where the needle went in is normal and usually goes away within a few days. [1]
Back pain after childbirth is common whether or not you had an epidural. [1] Large trials also found no difference in long-term backache between people who had a labor epidural and those who did not. [2]
When should you call a doctor after an epidural?
Call your doctor or get emergency care after an epidural if you develop any of these: [1]
Fever
Loss of bladder or bowel control
Numbness or weakness in your legs that lasts longer than expected
A severe headache when you sit or stand that improves when you lie down
Conclusion
An epidural is a safe and effective way to control pain during labor, surgery, and recovery, and a steroid epidural can ease nerve-related back pain for a few months. [1] Serious complications are rare, and the research shows labor epidurals relieve pain well without raising cesarean rates. [1][2]
The best preparation is simple: follow your fasting and medicine instructions, plan a ride home, rest for the first 24 hours, and know the four warning signs that need a call to your doctor.
Take this guide to your next appointment. Save or share this page and use the questions below with your doctor or anesthesia team. For more clear, evidence-based guides on pregnancy, back pain, and procedures, explore the Rinnit health library and read how we review medical content in our editorial policy.
Questions to ask your care team:
Which type of epidural do you recommend for me, and why?
Which of my medicines or supplements should I pause, and for how long?
How will I know the epidural is working, and how long should the numbness last?
Which symptoms afterward should make me call you?
FAQ
What is an epidural?
An epidural is an injection into the space around the spinal nerves that numbs pain or reduces nerve inflammation. It is used for labor, surgery, pain after surgery, and some types of back pain. [1]
How long does an epidural take to work?
An anesthetic epidural takes about 20 to 30 minutes to work. A steroid injection starts working within a few days. [1]
How long does an epidural last?
A single anesthetic injection usually lasts a few hours, and with a catheter, numbness lasts a few hours after the last dose. Relief from a steroid injection typically lasts a few months. [1]
Does an epidural hurt?
Most people feel a quick pinch from the numbing shot, then pressure. Tingling, burning, or a brief shooting pain can happen during the injection and usually fades. [1]
Can you walk after an epidural?
With a combined spinal-epidural in labor, most people keep some leg feeling and movement but cannot walk fully. After any epidural, avoid driving for at least 24 hours. [1]
Does an epidural cause long-term back pain?
Long-term back problems from an epidural are very rare. Short-term tenderness at the injection site is normal and usually settles within days. [1]
What are the risks of an epidural?
Risks are rare and include bleeding or infection at the injection site, a spinal fluid leak, nerve damage, medicine reactions, and spinal cord injury. [1]
When should I seek emergency care after an epidural?
Get care quickly for fever, loss of bladder or bowel control, leg numbness or weakness that lasts longer than expected, or a severe headache when upright that eases when lying down. [1]
Related reading
On Rinnit:
Trusted external resources:
References
Cleveland Clinic. Epidural. Cleveland Clinic Health Library. Last updated May 2, 2025. https://my.clevelandclinic.org/health/treatments/21896-epidural
Anim-Somuah M, Smyth RM, Cyna AM, Cuthbert A. Epidural versus non-epidural or no analgesia for pain management in labour. Cochrane Database of Systematic Reviews. 2018;5(5):CD000331. PMID: 29781504. https://doi.org/10.1002/14651858.CD000331.pub4
Verheijen EJA, Bonke CA, Amorij EMJ, Vleggeert-Lankamp CLA. Epidural steroid compared to placebo injection in sciatica: a systematic review and meta-analysis. European Spine Journal. 2021;30(11):3255-3264. PMID: 33974132. https://doi.org/10.1007/s00586-021-06854-9
Mims SC, Tan HS, Sun K, et al. Long-term morbidities following unintentional dural puncture in obstetric patients: a systematic review and meta-analysis. Journal of Clinical Anesthesia. 2022;79:110787. PMID: 35358942. https://doi.org/10.1016/j.jclinane.2022.110787
Medical disclaimer
This article is for general education only and does not replace advice from your doctor or anesthesia team. Decisions about an epidural, and any instructions before or after one, should come from the clinicians who know your medical history. If you have symptoms of an emergency, call your local emergency number.
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