Question: How Far Apart are Epidural Injections Performed?

I have herniated disc at L5-S1, spondylolisthesis grade 0-1 at L5-S1 and spondylolysis. I had an epidural injection (actually a caudal injection). Three days after, I started feeling better, although still far from normal. But I can drive sometimes for 30 minutes, sit 20-30 minutes, and walk 10 minutes. I am more functional than before.

My second injection was supposed to be two weeks later. However, when I called to make my appointment; it was scheduled for 6 weeks later, and no appointment was made for the third injection. I've read that it is recommended to have each ESI (epidural steroid injection) 2 weeks apart to get maximum results.

My question is: how important is how far apart are the injections done? Is it OK if I get the next injection six weeks after the first injection? I don't want the effect to wear off and I may get better. Is this a procedure that is better to have in a good hospital or can anybody do the injections (meaning I can go anywhere just to get them 2 weeks apart)?

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Doctor’s Response: The Time Does Not Matter Much for Epidural Injections

It probably does not matter all that much whether or not the epidural steroid injections are two weeks apart. The two weeks is more of a guideline that the injections should not be done any sooner than two weeks. Some people even do not have the second or third injection if they are doing very well, and that is probably why your third injection has not been scheduled yet. There really is nothing magical about having them done two weeks apart, this is just the soonest they can be linked together.

To answer your other question, a lot of different specialists do epidural injections, and it is not all that difficult of a procedure. They should be done under fluoroscopy, but it probably does not matter if they are done in a big hospital or a small one. Many office practices now even have a flouroscopy machine so they can be done right in a doctor’s office.

Finally, the epidural injections are primarily meant to provide enough pain relief so that you can progress with physical rehabilitation, and it’s the physical rehab that really helps you heal and feel better over the long term.

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In Spine-health’s Doctor Advice section, physicians respond to frequently asked questions about back pain issues. These responses represent the opinion of one physician, and do not necessarily reflect the views of the broader medical community. The advice presented has not been peer reviewed by Spine-health’s medical advisory board.