Epidural steroid injections (ESI) are often used as pain relief during labor. In other cases, doctors employ epidural steroid injections to manage chronic pain conditions like spinal stenosis, herniated discs, and sciatica. In either instance, there is often confusion about which sleeping positions best provide support after this procedure. Discomfort and lack of sleep are often the unfortunate consequences of this procedure that many struggle with. Whether after giving birth or otherwise, there are some pointers to keep in mind after an epidural procedure.

What is an Epidural? 

An epidural is essentially injecting medication into the epidural space surrounding your spinal nerves. Epidural steroid injections specifically place corticosteroid medication directly around a pinched nerve. Epidural steroid injections use corticosteroids to minimize inflammation and soothe irritated nerves. The injections help to provide temporary or long-term pain relief. Usually, the most commonly used steroids in epidural injections are dexamethasone, betamethasone, methylprednisolone, and triamcinolone. 

Misconceptions About Epidural Steroid Injections

There are certain misconceptions about epidural steroid injections that are worth noting too. Dr. Ashley Devers M.S., D.C., C.C.S.P., C.D.N. is a Perinatal specialist as well as a Sports and Injury specialist who is used to correcting misinformed patients about misconceptions and concerns around ESIs. “Epidural steroid injections are very common after traumatic injuries such as car accidents or slips and falls,” says Devers. The goal is to allow the ESI to reduce pain to help return to normal mobility and activities. 

Devers explains that after chiropractic treatment or physical therapy, healthcare physicians will often refer out for ESIs once maximum medical improvement has been reached and pain symptoms have not gone away completely. One of the most popular misconceptions relates to the idea of immediate bone density loss. “While frequent injections, more than 3 ESIs per year may affect bone density, oftentimes symptoms resolve and improve after one injection. This has little to no effect on bone density,” Devers explains. 

What Are The Best Positions To Sleep After An Epidural Steroid Injection?

Sleeping posture is extremely important after receiving an epidural. Even still, many are confused about the most recommendable position to depend on. “The injection occurs above and outside the spine and its dura. Since they are not punctured during the procedure, the best way to sleep is in a position that puts the least amount of stress and tension on the muscles that have been affected by the insertion of the needle,” says Dever. 

If the injection takes place in the cervical spine, it’s best to sleep on your back. Devers recommends using a pillow that will protect the curve of your neck and allow your head to curve back. 

If the injection occurs in the lower back, it might best to sleep on your back or on your side with a pillow at the waist to keep your muscles from straining and stretching in an unbalanced or awkward position for hours. 

“While everyone won’t be able to control the position in which they sleep, it is suggested to find a position that allows for the least amount of strain in your muscles as they heal from the procedure,” advises Dever. 

How To Prevent Further Pain Post-ESI

“It’s always best to follow your treating Doctor’s suggestions after receiving an ESI. Some of these suggestions include resting, restraining from lifting heavy objects, extending your head and looking up for more than a few minutes, and to make sure your workstation is ergonomically sound,” adds Dever. 

This advice is rooted in a healthy and progressive healing journey. Preventing injury and exacerbations while the inflammation is being reduced at the site of injection is critical according to Devers.  

The best position to sleep after epidural steroid injections depends on your body, injection site, and recommended recovery needs. Remember to follow the advice of your Doctor or healthcare provider to assist you in proper recovery from an ESI.