Epidural Injections

Digital illustration of lumbar injection for pain relief

Back pain moves through the leg, thereby stopping one’s activities, sleep, and quality of life. If you experience back pain, there’s a high chance that you are searching for relief through medicine rather than surgery.  Epidural Injections are a proven approach to relieving back and leg pain. At the Southwest Scoliosis and Spine Institute, our experts will explain the procedure to you so that you will know what to expect.

Epidural injections have now been embraced by the medical profession as a standard practice for treating back pain. Our doctors usually use this pain treatment caused by:

  • Spinal stenosis
  • Degenerative disc disease
  • Sciatica
  • Herniated discs
  • Radiculitis
  • Spondylosis, and
  • Radiculopathy

What are Epidural Injections?

Epidural injections contain a steroid medicine and a local anesthetic. The doctor injects the medicine into a gap in your back referred to as the epidural space — the space surrounding the spinal cord. The steroid helps in reducing inflammation around the spinal cord while the local anesthetic offers a painless injection. Doctors will give these shots in different areas along the back.

The Different Techniques


Epidural InjectionsA doctor will choose the route of administering an epidural injection based on his or her experience, the patient’s specific condition, and the results obtained from previous treatments for similar diagnoses.

Transforaminal route

In this technique, the shot goes into the space where the nerve is most likely irritated. This technique focuses on specific nerve roots to reduce inflammation and pain.


Interlaminar route

This technique involves inserting the needle in the back so that the medication can flow into the epidural space. Since this technique does not deposit the medication near the affected nerve root, the medicine can spread within the epidural space but is not as effective as other methods.

Caudal route

In this technique, the medication does not go to the source of the pain. Doctors state that this does not work as well as other methods, but it is safer and easier to perform. It helps in controlling diffused pain.

How Epidural Injections Work

The immune system acts as the body’s defense system. It helps in fighting off bacteria and viruses. If you are injured or a part of your body is not functioning correctly, the immune system protects the body.  The body does not tolerate inflammation for a long period; it is a temporary measure until the immune system achieves its goal. So, if inflammation persists for a long period, it leads to pain. When the adrenal gland secretes cortisone, it suppresses the immune system in the targeted area; thereby reducing inflammation and reducing pain.

When you are given an epidural injection, you are increasing the naturally occurring processes in your body. Instead of waiting for the adrenal gland to release cortisone, the doctor provides cortisone to help suppress the pain.


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Importance of Epidural Site Injections (ESI)

Most doctors will agree that ESI is useful during an acute period of back pain. However, the shots do not always work. When they are effective, the relief from pain is usually temporary (the relief can range from one week to one year). If the first injection works, you may receive about 3 injections in a year.

When epidural injections are given in the lumbar space, they may have the following benefits:

Reduce inflammation and nerve pain

ESI reduces the production of inflammatory chemicals and also reduces the sensitivity of nerve fibers to pain; this makes the nerve fibers generate fewer pain signals.

Reduce oral medication

Pain relief from ESI limits the need for taking oral medicine which tends to have side effects when taken for long periods.

Aid physical therapy

ESI provides relief that is enough to continue with physical therapy.

Postpone surgery

The relief from pain that ESI offer helps in postponing surgery. If physical therapy yields the required result, the shots can help eliminate the need for surgery.

Potential Risks of Epidural Injections

ESI is safe and minimally invasive for getting relief from back pain. However, some temporary side effects can occur. These include (but are not limited to):

  • Nausea
  • Fainting (vasovagal attack)
  • Post-injection pain
  • Dizziness
  • Headache
  • Flushing of the face

These side effects usually resolve within a few minutes to hours. Although serious problems are rare, they can occur. Some serious complications include dural puncture, spinal cord damage, and/ or stroke.

What to Expect Before, During, and After Epidural Injections

If you and your doctor agree to go forward with the procedure, it is important to know what to expect.


Before getting the epidural injection, your doctor will review your medical history, the current medications you’re taking, your allergies, and the potential risks that the injection has. If you are an expectant or nursing mother, or maybe you’re planning to get pregnant soon, ensure you inform the doctor.

Also, the doctor will review the necessary preoperative preparations. Patients should not drive after the procedure, so patients should ensure they arrange for someone that will drive them home. Put on comfortable clothing and also bring along something that will keep you occupied while waiting for the procedure.


The doctor will clean the skin around the injection site with an antiseptic. A local anesthetic will also get injected or sprayed on the area to numb the skin and deeper tissues. You will lie down on an X-ray table, which is very skinny.   The doctor will use fluoroscopy (a type of live X-ray) to guide him or her in inserting the needle toward the epidural space. The doctor will then release the medicine slowly.


The benefit of the steroids will take effect within a few days. Note that every patient is unique. If your symptoms persist after a week, the doctor will investigate other sources of the pain. The doctor may give patients additional injections if the pain only diminishes for a short period.

Frequently Asked Questions About Epidural Injections

How long does an ESI last?

It is not easy to forecast the shot’s duration or effect on pain.  In most cases, the immediate pain relief comes from the local anesthetic but reduces within a few hours. The steroid injection starts working between 2 to 7 days and this can last for several days to a year. Doctors may administer three repeat injections to reduce the pain. These injections are spaced two weeks apart from each other. These repeat injections should gradually reduce the pain. If you need to have more injections, ensure you wait for at least 6 months to a year before receiving more injections.

Is ESI suitable for everyone?

Epidural injections are not suitable for treating everybody. The medical specialist will tell you if you can get the injection. If you are taking a blood-thinning medication, are pregnant, or have an infection, inform your doctor. The doctor may need to postpone the injection for people that fall into those categories. Also, let your doctor know if you have a bleeding disorder or if you were allergic to previous injections.

Who carries out ESI?

Here at Southwest Scoliosis and Spine Institute, ESI is given by specialists. These professionals are well-trained and adept at safely performing this procedure.

Contact Us for Lasting Relief of ESI

The relief from pain, provided by epidural injection, can last from several days to a year. If you experienced just partial relief after the first injection, the doctor will administer a follow-up injection three weeks later. Typically, if you experience complete relief, no further injections are needed.

At Southwest Scoliosis and Spine Institute, we develop an individualized epidural injection schedule for each patient based on their symptoms.

As a strong believer in the use of epidural injections, our pain management services comprise pain relief via this non-invasive procedure. The Southwest Scoliosis and Spine Institute with offices in DallasPlano, and Frisco, Texas offers a multidisciplinary treatment for back pain through physical therapy and epidural injection intervention programs. Schedule an appointment with one of our board-certified and fellowship-trained doctors by calling 214-556-0555 and stop the pain.


Medline Plus – Epidural Injections
Radiology Info – Epidural Injections


If you or your loved one is suffering from back pain from a spinal condition, there is hope. We can help. Call Southwest Scoliosis and Spine Institute at 214-556-0555 to make an appointment today.