Lumbar Epidural Steroid Injections for Low Back Pain
Living with radiating back pain can be exhausting in ways that are hard to explain to people who haven’t experienced it. You stop going on walks, you skip the gym and you hesitate before picking up your grandchildren. You might even toss and turn at night, trying to find the most comfortable position.
As activity becomes more limited, new problems start to surface: weakened muscles, reduced mobility and a cycle of pain that becomes harder to break. For many, that cycle can lead to increased reliance on pain medication, including opioids, despite their risks and limitations.
Epidural steroid injections offer a different approach, delivering targeted anti-inflammatory medication directly around inflamed or compressed nerves. By reducing pain at the source, many patients are able to move more comfortably again and return to the daily activities they love.
What Are Epidural Steroid Injections?
An epidural steroid injection is a minimally invasive pain management procedure that delivers anti-inflammatory medicine (a corticosteroid) directly into the epidural space, the narrow area just outside the membrane surrounding the spinal cord. These injections reduce inflammation, calm aggravated nerves and provide meaningful, targeted relief at the source of your pain.
Epidural steroid injections have been used safely for decades and remain one of the most commonly performed interventional pain treatments in the U.S. At Orange County Pain Clinics, our physicians use fluoroscopic (X-ray) guidance during every injection to ensure accurate placement and consistent results.
What Can Epidural Steroid Injections Treat?
Epidural injections are used to treat radicular pain: the sharp, “electric” sensation that starts in the back and radiates outward along a compressed or inflamed nerve. Most people know it as pain, numbness or tingling that travels from the lower back down through the hip, buttock or leg. It can also affect the neck and arms when nerve compression occurs higher in the spine.
Radicular pain can stem from several underlying conditions, including:
- Herniated disc: When the soft, inner material of a spinal disc pushes through its outer casing and presses on a nearby nerve root
- Degenerative disc disease / spondylosis: Age-related “wear-and-tear” that narrows the space around spinal nerves
- Spinal stenosis: A narrowing of the spinal canal that puts pressure on the nerves passing through it, causing pain or cramping
Epidural injections can also be used to manage pain that develops as a result of sciatica.
Radicular pain affects people from all walks of life. It shows up in athletes who compete at high levels, desk workers with poor posture, and older adults whose spines have simply logged a lot of miles. No matter how it starts, the impact can affect every facet of your daily life, making even simple movements like sitting, standing or walking uncomfortable.
How Epidural Steroid Injections Work?
When you take an oral anti-inflammatory or pain reliever, the medication has to travel throughout the entire body before reaching inflamed nerve tissue in the spine. While they can help, oral medications are indirect, inefficient, and, for many people with lower back pain, not enough to make a real difference.
An epidural steroid injection delivers medication directly into the epidural space, reaching the nerves quickly for targeted pain relief. This can help you feel better sooner and reduce reliance on narcotic pain medication, including opioids, that carry greater risks and side effects. It can also reduce pain enough so you can increase your activity levels and participate in physical therapy, allowing your body’s own healing mechanisms to take over.
Are Epidural Steroid Injections Right for Me?
Epidural steroid injections work best for patients whose pain has a clear nerve-related cause. If conservative treatments like physical therapy, rest or oral medications haven’t provided adequate relief, an injection may be the logical next step. Beyond lower back pain, epidurals can also address radicular pain originating in the mid-spine or neck.
You may be a good candidate if you are experiencing:
- Shooting or burning pain that radiates from the spine into the arms or legs
- An acute episode of back or neck pain that is interfering with daily function
- Symptoms from a herniated disc, spinal stenosis or degenerative disc disease
- Nerve pain that has not responded sufficiently to physical therapy or oral medications
If these symptoms sound familiar, schedule a consultation with our team. Together, we can evaluate your condition and medical history to determine if an epidural steroid injection might be right for you. If you’re a good candidate, we’ll build a plan designed to reduce your pain, restore your mobility and help you get back to your normal routine with greater comfort and confidence.
What to Expect During a Lumbar Epidural Steroid Injection
The procedure itself is straightforward and typically takes less than 30 minutes from start to finish. You’ll lie on a procedure table, the skin over the injection site will be cleaned and a local anesthetic will be applied so you’re comfortable throughout. Using fluoroscopic (X-ray) guidance, your physician will carefully position the needle in the epidural space to ensure precise delivery of the medication.
At Orange County Pain Clinics, we also perform epidurals using the paramedian approach, a technique that’s particularly valuable for patients with arthritis who find it painful to flex their spine. Rather than entering from the midline, the needle is placed approximately 1.5 cm laterally and angled slightly downward, providing less resistance for the needle.
After the injection, patients are monitored in a recovery area for a short time before heading home. You may feel immediate pain relief from the local anesthetic, but this is temporary and typically fades within a few hours. The corticosteroid will begin working within a few days. Most patients notice meaningful improvement within three to five days.
How Long Does Relief Last?
Relief duration varies from patient to patient and depends largely on the underlying cause of the nerve compression. Some patients experience relief for several weeks; others find that a single injection holds for six months to a year. If a first injection provides partial but incomplete relief, a follow-up injection may be recommended. Most patients receive no more than three injections per year.
Epidural steroid injections are often most effective as part of a broader pain management plan. Our team at Orange County Pain Clinics takes an integrative approach, coordinating epidural injections with physical therapy, chiropractic care and other treatments available through our network to give you the best possible long-term outcome.
Meet the Specialists Behind Your Care
Epidural steroid injections at Orange County Pain Clinics are performed by a multidisciplinary team of physicians and spine specialists with extensive experience in interventional pain management, orthopedic care and rehabilitation. Our team includes medical doctors, physical therapists and chiropractic specialists who work together to diagnose the source of your pain and deliver targeted relief.
Frequently Asked Questions
What is an epidural steroid injection?
An epidural steroid injection is a minimally invasive procedure that delivers anti-inflammatory medication (a corticosteroid) into the epidural space around spinal nerves, reducing low back pain caused by nerve inflammation or compression.
Are epidural steroid injections painful?
Lower back injections typically involve little to no pain. Most patients feel mild pressure as the medication is administered. A local anesthetic is used to numb the area and keep you comfortable.
How long does it take for an epidural steroid injection to work?
Some patients feel temporary relief within hours from the local anesthetic, but the steroid usually begins reducing inflammation within a few days, with noticeable improvement often occurring within three to five days.
How many injections will I need?
That depends on your response to the first injection and the source of your pain. Some patients get significant, lasting relief from a single treatment. Others benefit from a short series of injections spaced several weeks apart. Our physicians take a measured approach and will only recommend additional injections if they’re likely to provide further benefit.
Can I get an epidural steroid injection if I take blood thinners?
Blood-thinning medications do affect your candidacy for this procedure, as they increase the risk of bleeding at the injection site. If you’re on anticoagulant therapy, let our team know. In some cases, your prescribing physician can advise on temporary adjustments, but this is a decision that should involve all of your care providers.
Will an epidural steroid injection help me avoid surgery?
For many patients, yes. Lumbar steroid injections can reduce nerve inflammation enough to allow the body to heal and manage pain long-term without surgical intervention. They won’t reverse structural changes like severe disc degeneration, but they can be a meaningful alternative for patients who are not ready for surgery.
Who shouldn’t get epidural steroid injections?
Patients with an active local infection near the injection site or who are currently taking blood-thinning medications are generally not candidates for this procedure. If you have known allergies, underlying health conditions or take multiple medications, bring a complete list to your consultation. Your physician will review everything before making a recommendation.