Procedure

Epidural steroid injection.

Anti-inflammatory medication delivered under live X-ray to a specific inflamed nerve root.

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What it is

An epidural steroid injection places corticosteroid into the epidural space — the area surrounding the spinal nerves — at the level where a nerve root is being irritated by a disc herniation, stenosis or arthritic narrowing. The aim is to reduce the inflammation around that nerve so the pain it is producing settles.

A large part of the pain from a disc herniation is chemical rather than purely mechanical: inflammatory material from the disc irritates the nerve. That is why reducing inflammation can help substantially even though the disc itself has not moved.

Dr. Loch performs these under live X-ray with contrast, which confirms the medication is spreading to the intended level before anything else is delivered. The approach — interlaminar, transforaminal or caudal — is chosen for your anatomy and the level involved.

Candidates

Who this is for

  • Sciatica or arm pain from a herniated or bulging disc
  • Nerve root pain from spinal stenosis
  • Radiculopathy with numbness or tingling in a nerve distribution
  • Leg pain that has not settled with time, medication and physical therapy

How it works

The appointment, step by step.

  1. 01

    Before

    Tell us about blood thinners in advance — some need to be held for a few days. Otherwise no special preparation. Eat normally unless we tell you otherwise.

  2. 02

    During

    You lie face down on the procedure table. The skin is cleaned and numbed. Under live X-ray, the needle is guided to the correct level, contrast confirms placement, and the medication is delivered. Usually under fifteen minutes.

  3. 03

    After

    Short observation, then home. Local anaesthetic may relieve your pain for a few hours; note how much, it tells us something. Some soreness at the site for a day or two is normal.

  4. 04

    Over the next two weeks

    Steroid effect builds over several days to two weeks. We follow up to establish what actually happened before deciding on anything further.

Questions about this procedure

Is this the same as an epidural during childbirth?
Same anatomical space, different purpose and technique. This delivers anti-inflammatory medication precisely to an inflamed nerve root under X-ray guidance, rather than continuous anaesthetic.
What are the risks?
It is a commonly performed procedure with a good safety record, but no procedure is risk-free. Dr. Loch will go through the specific risks — including infection, bleeding, headache and, rarely, nerve injury — before you consent.
What if it does not work?
That is useful information. If a well-placed injection at the correct level does not change your pain, it argues the nerve root is not the main source — and we revisit the diagnosis rather than repeating the same procedure.

Eliminate pain and reclaim your life.

Request an appointment with Dr. Loch, or call the office at (904) 750-3787. Most patients are seen within a week.

Request an appointment