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Lumbar Epidural Injection

A lumbar epidural steroid injection, guided by live X-ray, calms swollen nerve roots. It eases sciatica, radiating leg pain, and spinal stenosis. Given by our board-certified pain doctors at Remix Medical in Houston, TX.

Lumbar Epidural Steroid Injection in Houston, Texas

When a lumbar disc presses on a nerve root, the problem is not only mechanical. The disc releases inflammatory chemicals that sensitize the nerve, and much of the pain that runs down the leg comes from that inflammation rather than the compression itself. A lumbar epidural steroid injection places anti-inflammatory medication exactly where that process is happening.

What is a Lumbar Epidural Injection?

The epidural space is the sleeve surrounding the spinal cord and nerve roots. A lumbar epidural steroid injection delivers corticosteroid and local anesthetic into that space at the affected level of the lower back, under live fluoroscopic (X-ray) guidance.

It is the most commonly performed interventional pain procedure in the United States, and one of the best studied.

StageWhat happens
BeforeYou're positioned, the skin is cleaned and numbed, and live imaging (fluoroscopy or ultrasound) guides the needle
DuringThe medication is placed precisely at the epidural space in your lower back; most people feel pressure more than sharp pain
AfterYou rest briefly and go home the same day — arrange a driver if you received sedation

When It Is Used

  • Lumbar radiculopathy and sciatica from a herniated or bulging disc
  • Spinal stenosis with leg pain and neurogenic claudication
  • Degenerative disc disease with radiating symptoms
  • Post-surgical radicular pain where a nerve root remains irritated

It is most effective for pain that radiates into the leg. It is less effective for pain confined to the back alone.

Approaches

Interlaminar — the needle enters the midline of the epidural space and medication spreads across several levels. Useful when symptoms are bilateral or the level is uncertain.

Transforaminal — the needle is directed to the specific opening through which the nerve root exits, depositing medication directly onto the inflamed root. More targeted, and doubles as a diagnostic test of which level is responsible.

Caudal — entry through the sacral hiatus at the base of the spine, useful after prior surgery when the anatomy above is scarred.

Your physician selects the approach based on your imaging, your symptom pattern, and your surgical history.

Relief from Radiating Leg Pain at Remix Medical

An epidural injection is not a cure for a herniated disc. What it does is reduce inflammation enough that the disc has time to resorb and you have room to rehabilitate. Most patients who respond do so within one to two weeks.

How it's performed

The patient lies prone on a fluoroscopy table and the skin is anesthetized. Under live X-ray guidance, a needle is advanced into the lumbar epidural space using an interlaminar, transforaminal, or caudal approach. Contrast dye confirms correct placement and spread, and rules out vascular uptake. A corticosteroid and local anesthetic solution is then injected around the affected nerve root.

How to prepare

Arrange a driver for the day of the procedure. Discontinue blood thinners only as directed by the prescribing physician. You may eat lightly unless sedation is planned. Bring recent MRI or CT imaging and a current medication list. Notify the office if you have an active infection, fever, or uncontrolled diabetes.

What to expect after

Ice the injection site 20 minutes every 2 to 3 hours for the first day. Avoid strenuous activity, heavy lifting, and driving for 24 hours. Expect a possible temporary increase in pain for 1 to 2 days as the anesthetic wears off before the steroid takes effect. Monitor blood glucose closely if diabetic. Report fever, severe headache, new weakness, or loss of bladder or bowel control immediately.

Outcome

Most appropriately selected patients experience meaningful reduction in radiating leg pain, with benefit typically lasting weeks to months. Relief creates a window to progress with physical therapy and, in many cases, allows a herniated disc time to resorb naturally.

Frequently asked

Lumbar Epidural Injection questions, answered

What is a lumbar epidural steroid injection?

It's an injection of anti-inflammatory medication into the epidural space around the nerves in your lower back. It's used to calm an irritated nerve causing back or leg pain.

What conditions does a lumbar epidural treat?

It's commonly used for sciatica, a herniated disc, or spinal stenosis, when a nerve in the lower back is inflamed. It can ease leg pain enough to progress with therapy.

How long does an epidural steroid injection last?

Relief varies widely, from a few weeks to several months. It's often used to open a window for physical therapy, and it may be repeated.

When should I call after an epidural injection?

Mild soreness is expected, but call for fever, severe or worsening pain, new weakness, or loss of bladder or bowel control, which are uncommon but need urgent attention.

Does a lumbar epidural injection hurt?

The skin is numbed and live imaging guides the needle, so most people feel pressure more than sharp pain. Some soreness afterward is normal.

SpecialtyPain ManagementTypeProcedureBody locationLumbar spine, lumbar epidural space, L4-L5, L5-S1, lumbar nerve rootsCPT code62322 (interlaminar, without imaging), 62323 (interlaminar, with imaging); 64483 (transforaminal, single level), 64484 (each additional level); 62324/62325 (continuous infusion)

Also called Lumbar ESI, Epidural Steroid Injection, Transforaminal Epidural Injection, Interlaminar Epidural Injection, Caudal Epidural Injection, Nerve Root Injection

This page is for general education and is not a substitute for medical advice. Whether a given procedure is appropriate depends on your individual evaluation. Contact a Remix Medical clinician to discuss your care.

Updated July 9, 2026. Medically reviewed by Raju Mantena, DO.

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