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Lumbar Epidural InjectionFluoroscopically guided lumbar epidural steroid injections to reduce nerve root inflammation and relieve sciatica, radiating leg pain, and spinal stenosis symptoms — performed by board-certified pain management physicians at Remix Medical in Houston, TX.

Specialty
Pain Management
Type
Procedure
Body location
Lumbar spine, lumbar epidural space, L4-L5, L5-S1, lumbar nerve roots
CPT code
62322 (interlaminar, without imaging), 62323 (interlaminar, with imaging); 64483 (transforaminal, single level), 64484 (each additional level); 62324/62325 (continuous infusion)

Also known as: Lumbar ESI, Epidural Steroid Injection, Transforaminal Epidural Injection, Interlaminar Epidural Injection, Caudal Epidural Injection, Nerve Root Injection

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.

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.

Contact Remix Medical to schedule a consultation with a board-certified pain management physician in Houston.

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.

Your physician

Your pain management at Remix Medical.

Every clinician at Remix Medical is board-certified and owns the practice — so the physician in your exam room is the one making decisions about your care.

  • Raju Mantena, DO

    Pain Medicine Physician

    Medical Center — South Freeway · Montrose — Upper Kirby · Pearland

    Board certifiedAccepting newBook

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.

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