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Epidural steroid injections are categorized into the following three types.

Intralaminar epidural injections delivered to the thin layer between two vertebrae. These injections access the layer from the midline of the spine, spread to adjacent areas, and offer short-term relief.
Transforaminal epidural steroid injections that are delivered from a side close to the nerve root and the needle follows the nerve exit at the spine. Used to perform nerve block, these injections make more concentrated medication delivery offering longer relief.
Caudal epidural steroid injections are delivered through a tiny opening just above the tailbone. Such injections use a catheter and allow the steroid to spread over several segments on both sides. The procedure targets a group of nerve roots providing relief.

Epidural steroid injections have been found to be effective in ensuring semi-permanent relief for patients with nerve root inflammation and pain linked to the following disorders.

Spinal stenosis or abnormal narrowing of the spinal canal
Bilateral radicular pain
Lumbar Transforaminal Epidural
Radiculopathy or compressing of spinal nerve roots
Spondylysis or degeneration of intervertebral discs causing nerve impingement and neck pain
Pain from a pinched nerve due to herniated or bulging disc
Radicular cervical pain or radiating pain due to pinched cervical spinal nerves
Radicular lumbar pain or radiating pain due to pinched lumbar spinal nerves
Leg pain following sciatica
Slipped disc causing nerve pinching
Nerve root inflammation and pain
Lower back pain
Leg pain due to radiating lower back pain

A patient is recommended for epidural steroid injections when conservative treatments fail to control the pain symptoms. In many cases, it is used as a last resort prior to surgical intervention.

The number and frequency of epidural steroid injections are subject to patient’s condition, medical guidance, and success of these injections.

Epidural steroid injections are administered in an outpatient setting. The skin above and soft tissues around the pain area is numbed with a local anesthetic. A needle is inserted into the epidural under fluoroscopic x-ray depending on intralaminar, transforaminal, or caudal type of steroid injection.

Many doctors use dye prior to injecting steroid to confirm that the needle is placed correctly. Once the position is confirmed, the steroid medication is inserted.

Epidural steroid injections usually have a mixture of steroid and a local anesthetic. The local anesthetic numbs the nerve roots and prevents transmission of pain signals to the brain. The steroid reduces the inflammation and treats the pinched nerve.

An epidural steroid injection process is over in 20 to 30 minutes.

Patients are advised overnight rest at home. However, there is no need to stay in the hospital. Patients are discharged once the injection is administered.

Injection-site soreness is the most common side effect. Infection or irritation may develop at the injection site. Unless carried under fluoroscopic guidance and expert clinics, you may face the risk of damage to soft tissues, blood vessels, and nerves.

Steroid may be allergic to many patients and influence blood sugar and blood pressure levels. Epidural steroid injections are not suggested for pregnant women and those with bleeding and infection risks.

Epidural steroid injections provide semi-permanent pain relief, but no cure. A number of research studies indicate 75 to 90% success rate of these injections. A 2007 study by the Florida Spine Institute claims that patients with spinal stenosis experiences significant improvement following epidural steroid injections. They can walk and stand without any pain symptoms. The Pain Physician journal reports successful use of the procedure to control lumbar back pain.

According to Skeletal Radiology journal, epidural steroid injections provide significant and immediate pain relief to 72 percent patients suffering from radiculopathy pain in the cervical area. As far as herniated disc with sciatica is concerned, these injections offer benefits equal to surgery, claims a report in the Journal of the American Medical Association.