Lumbar Epidural Steroid Injection
A lumbar epidural steroid injection (ESI) is one of the most commonly performed procedures in pain management — and for good reason. When disc herniation, spinal stenosis, or degenerative disc disease compresses or irritates a nerve root, the resulting inflammation produces pain, numbness, tingling, and weakness that can radiate down the leg. A targeted anti-inflammatory steroid injection into the epidural space directly addresses the source of this inflammation.
Dr. Edward Rubin performs lumbar epidural steroid injections under fluoroscopic (live X-ray) guidance to ensure precise needle placement and maximum safety.
What Conditions Does a Lumbar ESI Treat?
- Herniated or bulging lumbar disc with leg pain (sciatica)
- Lumbar spinal stenosis with neurogenic claudication
- Degenerative disc disease with radiculopathy
- Post-surgical epidural fibrosis (scar tissue pain after back surgery)
- Acute disc herniation with severe radicular pain
How the Procedure Works
You lie face-down on a fluoroscopy table. The skin and deeper tissues are numbed with local anesthetic. Under live X-ray guidance, Dr. Rubin advances a needle to the epidural space — the area between the spinal cord and the bony vertebral canal. Once confirmed with contrast dye, a combination of steroid (typically triamcinolone or methylprednisolone) and local anesthetic is injected.
The procedure takes approximately 15–20 minutes. You may feel temporary pressure or a familiar reproduction of your usual leg pain as the medication is delivered — this is expected and brief.
What to Expect After the Injection
- Day 1–2: Some patients notice increased soreness from the needle; this is temporary
- Days 3–7: Many patients begin to notice pain reduction as the steroid takes effect
- Peak benefit: Typically 1–3 weeks after the injection
- Duration: 6 weeks to 6 months depending on the individual and condition
Some patients achieve long-lasting relief after one injection. Others benefit from a series of up to three injections spaced 4–6 weeks apart within a 12-month period.
Safety and Risks
Lumbar ESIs are very well-tolerated. Performed under fluoroscopic guidance, the risks of needle misplacement are minimized. Possible side effects include temporary soreness at the injection site, transient flushing, or a brief flare in pain (lasting 1–2 days). Rare risks include infection, bleeding, or nerve irritation.
Patients with diabetes should monitor blood glucose closely for 1–2 weeks after the injection, as steroids can temporarily elevate blood sugar.
Frequently Asked Questions
Does the injection hurt? The numbing injection causes a brief sting. The epidural needle placement is well-tolerated; most patients describe pressure rather than pain.
How many injections will I need? This is individualized. Some patients need one; others benefit from a series of two or three. If injections are not providing durable relief, Dr. Rubin will discuss other options such as radiofrequency ablation or surgical consultation.
Can I drive home? You should not drive for several hours after the procedure due to the local anesthetic. We recommend bringing a driver.
Schedule Your Appointment
Call our Lake Success or Garden City office at 516-492-3100 to discuss whether a lumbar epidural steroid injection is appropriate for your pain.