Investigating the Link: Do Epidural Shots Cause Weight Gain?

October 6, 2025 •

4 min read

An estimated 9 million epidural steroid injections (ESIs) are performed annually in the United States [1.4.4]. A common patient concern is whether these shots cause weight gain, a side effect linked to the corticosteroid medication used [1.2.4].

Quick Summary

While epidural steroid injections can lead to weight gain, it is not a common side effect [1.2.2]. The gain is often temporary fluid retention or increased appetite caused by the corticosteroid, not a direct result of the injection itself [1.2.2, 1.3.1].

Key Points

The Steroid Connection: Weight gain from epidural shots is linked to the corticosteroid medication, which can increase appetite and cause fluid retention [1.3.1, 1.3.2].
Not a Common Side Effect: Multiple studies and sources indicate that significant weight gain is not a common or guaranteed side effect of epidural steroid injections [1.2.2, 1.2.3].
Fluid vs. Fat: Much of the initial weight increase, if it occurs, is often temporary water weight from fluid retention, not an accumulation of body fat [1.3.2, 1.9.1].
Dosage and Frequency Matter: The risk of side effects, including weight gain, is related to the dose and frequency of injections. It is more associated with long-term, high-dose use [1.3.4, 1.9.4].
Labor Epidurals Are Different: Epidurals for childbirth do not contain steroids; they use local anesthetics and are not associated with this side effect [1.7.1].
Management is Possible: Patients can proactively manage potential weight changes by limiting sodium, staying hydrated, eating a high-protein/fiber diet, and exercising as tolerated [1.5.1, 1.5.3].

What Are Epidural Shots and Why Are They Used?

Epidural steroid injections (ESIs) are a common treatment for various types of pain, particularly radicular pain (nerve root pain) stemming from the spine [1.2.3]. They are frequently used to manage conditions like herniated discs, spinal stenosis, and sciatica by delivering a potent anti-inflammatory medication—a corticosteroid—directly to the source of pain in the epidural space of the spine [1.2.3, 1.7.4]. The goal is to reduce inflammation and relieve pain, thereby improving function and allowing a patient to engage in physical therapy. While effective for many, concerns about potential side effects are common, with weight gain being a frequent question [1.2.4].

The Core Question: Do Epidural Shots Cause Weight Gain?

Research and clinical observations present a nuanced answer. Several studies have concluded that epidural steroid injections do not cause significant weight gain, especially in the long term [1.2.3, 1.2.4, 1.9.2]. One prospective study following 100 patients found no significant change in weight after a series of three monthly ESIs [1.2.3].

However, the potential for weight gain exists and is linked directly to the corticosteroid component of the injection [1.3.1]. Corticosteroids, whether taken orally or injected, can affect the body's metabolism, fluid balance, and appetite [1.3.1, 1.3.2]. It is important to distinguish between temporary weight fluctuations from fluid retention and an actual increase in body fat [1.3.2]. While most patients do not experience the typical systemic side effects seen with oral steroids (like prednisone), some individuals may notice changes [1.2.1, 1.9.4].

How Corticosteroids Can Lead to Weight Changes

The mechanisms by which the steroids in an ESI might influence weight include:

Increased Appetite Steroids can stimulate the appetite center in the brain, making you feel hungrier and potentially leading to increased calorie consumption [1.3.1, 1.3.2, 1.10.3].
Fluid Retention Corticosteroids can alter the way the body handles salt and water, causing the body to hold onto more sodium. This leads to fluid retention (edema), which can register as temporary weight gain on the scale [1.3.2, 1.9.1]. This is one of the more common, though still not guaranteed, side effects [1.2.2].
Changes in Fat Distribution With long-term or high-dose use, steroids can change how the body stores fat, sometimes leading to deposits in the abdomen, face ('moon face'), or the back of the neck [1.3.2, 1.3.4]. This is more characteristic of long-term oral steroid use than intermittent injections [1.9.4].

Labor Epidurals vs. Pain Management Epidurals

It is crucial to distinguish between epidurals used for pain management and those used during childbirth.

Pain Management Epidurals These injections typically contain a corticosteroid to reduce inflammation and an anesthetic for pain relief [1.7.4]. The steroid is the component linked to potential weight gain.
Labor and Delivery Epidurals These primarily use local anesthetics (and sometimes narcotics) to block pain signals during labor [1.7.1, 1.7.2]. They do not contain steroids and are therefore not associated with steroid-induced weight gain.

Comparison of Chronic Back Pain Management Strategies


Feature	Epidural Steroid Injections (ESIs)	Physical Therapy	Oral Medications (e.g., NSAIDs)
Mechanism	Delivers targeted anti-inflammatory steroid to the nerve root [1.2.3].	Strengthens muscles, improves flexibility, and corrects posture to reduce strain [1.6.5].	Provides systemic (whole-body) pain relief and inflammation reduction [1.6.2].
Primary Goal	Short-to-medium term pain and inflammation reduction [1.2.4].	Long-term functional improvement and pain self-management [1.6.5].	Management of acute or ongoing pain symptoms [1.6.2].
Risk of Weight Gain	Possible but not common; linked to steroid effects like fluid retention or increased appetite [1.2.2, 1.3.1].	Unlikely; structured exercise often supports weight management [1.5.2].	Varies by medication; some can have weight-related side effects.
Onset of Relief	Typically within 2-7 days [1.10.3].	Gradual, over weeks or months of consistent work [1.6.2].	Can be rapid (within hours) but requires ongoing dosage [1.6.2].

Managing Potential Weight Gain After an ESI

If you are concerned about weight gain, proactive steps can help mitigate the risk. The focus should be on managing the potential increase in appetite and fluid retention [1.5.1].

Monitor Your Diet: Focus on a diet rich in protein and fiber to help you feel full and control hunger [1.5.3]. Eating smaller, more frequent meals can also help regulate appetite [1.5.5].
Limit Sodium Intake: Reducing salt intake can help manage or prevent fluid retention. Avoid highly processed foods, which are often high in sodium [1.5.2, 1.5.3].
Increase Potassium: Eating potassium-rich foods like bananas, spinach, and oranges can help counterbalance sodium's effects on fluid balance [1.5.2].
Stay Active: Engage in regular, low-impact exercise as approved by your doctor. Physical activity helps burn calories and can counteract some metabolic effects of steroids [1.5.3, 1.5.4].
Stay Hydrated: Drinking plenty of water can paradoxically help your body release retained fluid [1.5.1].

Other Potential Side Effects

While generally safe, ESIs have other potential temporary side effects, including a temporary increase in pain, facial flushing, headaches, and elevated blood sugar levels, particularly in people with diabetes [1.2.1, 1.10.2]. Serious complications like nerve damage, bleeding, or infection are very rare [1.8.3, 1.8.4].

Conclusion

The concern that epidural shots cause weight gain is understandable, but significant, long-term weight gain is not a typical outcome [1.2.3, 1.9.2]. The potential for weight change stems from the corticosteroid's ability to increase appetite and cause fluid retention [1.3.2]. This effect is often temporary and manageable with diet and exercise [1.5.1, 1.5.4]. It is essential for patients to discuss all potential risks and benefits with their healthcare provider, who can offer personalized advice based on their health status and the dosage of the injection. Any weight gain experienced is often reversible after the course of treatment is complete [1.5.4].

For more information on epidural steroid injections, you can visit Spine-health.

Frequently Asked Questions

Most people do not gain a significant amount of weight. Studies have shown no significant change in weight after a series of injections [1.2.3, 1.9.2]. Any gain is usually minor and often due to temporary fluid retention [1.2.2].

No, weight gain associated with steroid injections is typically not permanent. Weight gained from fluid retention may resolve quickly, while any fat gain can be lost over the months following the discontinuation of treatment [1.5.3, 1.5.4].

The systemic effects of corticosteroids are related to the total dose used, not the specific application method or location like the neck (cervical) or low back (lumbar) [1.2.4]. The risk is tied to the drug itself, which can have body-wide effects.

If weight gain occurs, it can start within a few days to a week, often appearing as fluid retention or an increased appetite [1.10.3]. The onset varies greatly among individuals [1.5.3].

Yes, regular physical activity, as approved by your doctor, is recommended. Exercise helps counteract the metabolic effects of steroids and burn extra calories from any increase in appetite [1.5.3, 1.5.4].

Yes, alternatives include physical therapy, oral anti-inflammatory medications (NSAIDs), nerve blocks, and radiofrequency ablation [1.6.1, 1.6.2]. Physical therapy in particular is unlikely to cause weight gain and often promotes weight management [1.5.2].

Weight gain is a much more common and pronounced side effect of long-term oral steroids like prednisone [1.9.4]. Epidural injections deliver a localized dose, and while some of the steroid is absorbed systemically, the overall exposure and risk of side effects like weight gain are generally lower than with daily oral medication [1.2.4].