Epidural steroid injections at PHI are performed by board-certified physicians Dr. Faisal Lalani and Dr. Nadiv Samimi in our affiliated surgical suite under fluoroscopic guidance. They treat radiating pain from herniated discs, spinal stenosis, sciatica, and other causes of spinal nerve irritation across the cervical, thoracic, and lumbar regions.
What an Epidural Steroid Injection Does
An epidural steroid injection delivers a powerful anti-inflammatory medication directly to the source of nerve pain in your spine. The medication is placed in the epidural space, the area immediately surrounding your spinal nerves, where inflammation from a herniated disc, arthritis, or other spinal condition is irritating the nerve and causing pain.
Because the medication goes directly to the inflamed area, the dose required is far smaller than what you would need to take orally to achieve the same anti-inflammatory effect at the nerve. This is why an injection often produces meaningful relief that pills cannot.
The procedure does not address the underlying anatomical cause of your pain. It addresses the inflammation that the underlying cause is producing. For many patients, that inflammation is the actual source of their daily symptoms, and reducing it produces real relief that lasts months at a time.
How the Procedure Works
The injection is performed in our affiliated surgical suite under fluoroscopic guidance with an imaging specialist. The physician uses real-time imaging to confirm precise needle placement before any medication is delivered. Spinal injections without image guidance carry meaningfully higher risk and lower accuracy.
You are positioned comfortably, and the injection site is cleaned and numbed with a local anesthetic. The physician advances a thin needle to the epidural space, confirms position with imaging, and delivers a combination of corticosteroid and local anesthetic. The procedure typically takes about 20 minutes, depending on the levels treated and what is being performed.
PHI offers a range of comfort options, from local anesthetic to nitrous oxide, conscious sedation (Versed), or deep sedation (Propofol). You leave the same day; patients who receive only local anesthetic typically drive themselves home, while patients who receive sedation arrange transportation.
Three Regions We Treat
Cervical Epidural Steroid Injections
The cervical region is the upper spine, from the base of the skull to the top of the shoulders. A cervical epidural injection treats pain that originates in the neck and radiates into the shoulder, arm, or hand, including cervical radiculopathy, herniated disc, and spinal stenosis. These demand the highest precision and are performed only under image guidance.
Thoracic Epidural Steroid Injections
The thoracic region is the middle of the spine, behind the ribs. Thoracic epidural injections are less common than cervical or lumbar but are appropriate for specific conditions, including thoracic radiculopathy, herniated disc, post-surgical thoracic pain, and postherpetic neuralgia following shingles.
Lumbar Epidural Steroid Injections
The lumbar region is the lower back, from below the ribs to the pelvis. Lumbar epidural injections are the most common by far and treat pain that radiates down the buttock, leg, and sometimes into the foot, including lumbar radiculopathy and sciatica, herniated disc, spinal stenosis, and degenerative disc disease.
When Epidural Steroid Injections Are the Right Option
Epidural injections fit when
- You have radiating pain that travels from your spine into an arm, leg, or other extremity
- Your pain is caused or worsened by inflammation around a spinal nerve
- Conservative treatments like physical therapy, anti-inflammatory medication, and activity modification have not provided adequate relief
- Your imaging confirms a likely inflammatory or compressive source of nerve irritation
Not the right starting option when
- Your pain is purely localized in the spine without radiation (facet injections may fit better)
- Your pain originates from joint structures rather than nerve compression
- Your imaging shows mechanical instability that injections will not address
- You have a contraindication to corticosteroids or are on certain blood thinners
Your physician will tell you which category you fall into during consultation. Some patients arrive for an injection consultation and leave with a different recommendation, including facet injections, radiofrequency ablation, or a regenerative protocol. That is the point of an evaluation.
Why Patients Choose PHI for Epidural Steroid Injections
Convenient surgery center
Many practices perform these injections in a procedure room within a standard office. PHI performs every injection in our affiliated surgery center, a same-day, hospital-grade environment.
Image-guided every time
Every injection is performed under fluoroscopic guidance with an imaging specialist. Image guidance confirms needle placement before any medication is delivered.
Two board-certified physicians
Dr. Faisal Lalani and Dr. Nadiv Samimi, both trained in interventional pain at Cedars-Sinai. You meet your physician at consultation and the same physician performs your procedure.
Follow-up after every injection
PHI follows up after every injection, tracks your response, and evaluates whether a next step such as radiofrequency ablation or a regenerative protocol fits.
Concierge model
Single-physician continuity from consultation through follow-up, with direct access. International patients receive coordinated travel and scheduling.
Concierge, coordinated care
Single-physician continuity from consultation through treatment and return to activity. Patients receive clear guidance and transparent pricing at consultation.
What to Expect: Before, During, and After
Consultation and prep
Your physician reviews your imaging, history, and current medications at consultation. Some medications, including certain blood thinners, must be paused before the procedure; you will receive specific instructions. Plan to eat lightly the morning of the procedure.
The injection
The injection itself typically takes about 20 minutes, depending on the levels treated and what is being performed. PHI offers a range of comfort options, from local anesthetic to nitrous oxide, conscious sedation (Versed), or deep sedation (Propofol). Most patients describe the procedure as briefly uncomfortable rather than painful.
Recovery
You rest in our recovery area while your physician confirms you are stable. Activity restrictions for the rest of the day depend on the sedation used and vary from patient to patient.
Onset
The local anesthetic often produces immediate relief that wears off within hours; this is expected. The corticosteroid then takes effect. We tell patients it can take 7 to 10 days to feel relief, and we like to set realistic expectations.
Lasting relief
Most patients experience their full benefit within two weeks. Relief typically lasts several months, though duration varies based on the underlying condition and how long you had pain before the injection.
Frequently Asked Questions
Duration varies widely. Some patients experience months of relief from a single injection. Others find injections are part of a longer-term plan with periodic repeat doses. Patients with newer pain generally have better and longer-lasting responses than patients with pain present for a year or more.
It depends on the option you choose. PHI offers local anesthetic, nitrous oxide, conscious sedation (Versed), and deep sedation (Propofol). Your physician helps you choose the right level of comfort for your procedure.
Most patients describe the procedure as briefly uncomfortable rather than painful. The local anesthetic numbs the skin and tissue along the needle path. The most noticeable sensation is usually a sense of pressure when the medication is delivered.
If you receive only local anesthetic, most patients drive themselves home. If you receive any sedation, arrange transportation, as you should not drive the same day.
Epidural steroid injections are well-established procedures with a strong safety profile when performed under image guidance. Risks include temporary increase in pain, headache (especially with cervical injections), bleeding or infection at the injection site, and rare complications related to inadvertent intravascular injection. Image guidance significantly reduces these risks. Your physician will review the full risk profile at consultation.
It depends on the specific medication. Some blood thinners must be paused before the procedure; others, including aspirin in some doses, can typically be continued. Your physician will review your medications at consultation and provide specific instructions.
An epidural injection treats nerve pain that radiates from your spine into an arm or leg. A facet injection treats pain coming from the small joints between your vertebrae, which is usually felt locally in the spine itself. Your physician will recommend which one fits based on your symptom pattern and imaging.
An epidural injection reduces inflammation around an irritated nerve and provides relief for several months. Radiofrequency ablation interrupts the pain signal from a specific nerve for longer-lasting relief, typically 6 to 18 months, but it is appropriate for different pain patterns, most often facet-mediated pain rather than radiating nerve pain.
If a properly placed epidural injection does not produce meaningful relief, this is diagnostic information. It tells your physician that inflammation around the nerve is likely not the primary driver of your pain. The next step is usually to revisit imaging and consider a different approach, including facet injections, radiofrequency ablation, regenerative options, or surgical evaluation in selected cases.
Insurance coverage and payment options may vary. All pricing is disclosed at consultation.
Yes. PHI regularly treats patients from outside Los Angeles, including Las Vegas, Palm Springs, London, and other international locations. For patients traveling specifically for an epidural steroid injection, we coordinate consultation, imaging review, and procedure scheduling within a single visit when possible.