When should I contact a doctor after an epidural injection?

1. Immediate (hours): call now for severe or allergic reactions

If breathing difficulty, throat swelling, hives, sudden severe headache, fainting, or other signs of a serious allergic or anaphylactic reaction appear in the hours after the injection, seek emergency care or call the clinic immediately; such acute reactions are the classic reasons to get urgent help (statements on acute reactions and monitoring after injection are emphasized in clinic post-procedure guidance and specialist summaries) ^{[4] [7]}.

2. First day to 48 hours: expected discomfort versus concerning worsening

Mild local soreness, transient numbness from the numbing medication, or a temporary increase in pain for up to 24–72 hours can be normal as the anesthetic wears off and the steroid begins to act ^{[6] [8] [5]}. Contact the provider if severe pain persists beyond 24 hours, if pain is markedly worse rather than transiently worse, or if the headache/backache/neurologic symptoms are not improving as expected (Memorial Sloan Kettering advises calling for severe pain or pain lasting longer than 48 hours) ^[5].

3. Neurologic red flags any time: call urgently

New or worsening numbness, weakness in a leg or arm, inability to walk safely, or loss of bladder or bowel control are urgent neurological warning signs and should trigger immediate contact with the clinic or emergency services, because these suggest nerve compression, infection or rare procedural complications that require rapid evaluation (interventional pain follow‑up and specialist notes stress monitoring for adverse neurologic effects and reassessment) ^{[7] [4]}.

4. Signs of infection at the injection site or systemic infection: call now

Fever, increasing redness, warmth, swelling or drainage at the injection site should prompt immediate contact; clinics routinely warn patients to report persistent fever or local signs of infection because although rare, post‑injection infection requires prompt treatment ^{[4] [9] [10]}.

5. Medical and metabolic concerns: diabetes and medication interactions

Patients with diabetes may experience elevated blood glucose after steroid injections and are advised to contact their primary care clinician for management if sugars rise; additionally, any unexpected systemic effects—new shortness of breath, chest pain, severe palpitations, or other concerning systemic symptoms—should be reported (Cleveland Clinic guidance and other aftercare pages highlight glucose changes and systemic side effects) ^{[6] [4]}.

6. Follow-up timeline: routine check-ins and when to call if no progress

Clinics commonly recommend a scheduled follow‑up in about 2–3 weeks to assess response because the steroid’s full effect can take up to 10–14 days, while some practices suggest checking in at one week if there’s no improvement; if pain or function have not meaningfully improved by one week to two weeks, patients are typically asked to call to discuss next steps such as physical therapy, medication adjustments, or repeat injections (many sites advise a 2–3 week follow‑up and some suggest contacting the office if not improved after one week) ^{[2] [1] [11] [12]}.

7. Practical rule-of-thumb and limits of the reporting

A practical synthesis from the sources: seek emergency care for life‑threatening or rapidly progressive symptoms; call the clinic within 24–48 hours for severe, persistent or worsening pain; report fever, redness, drainage or neurologic changes immediately; and keep the routine 1–3 week follow‑up so the care team can assess steroid effect and next steps ^{[5] [4] [2]}. The provided sources do not supply precise incidence rates for complications or individualized thresholds tied to comorbidities, so clinicians’ individualized post‑procedure instructions should take precedence where they differ from these general guidelines ^{[7] [13]}.