At TOPS Institute, our board-certified interventional pain management specialists perform image-guided epidural procedures for patients throughout Los Angeles, Beverly Hills, and Southern California. Each treatment is carefully selected based on the location of your symptoms, imaging findings, medical history, and response to previous care.
Our goal is to reduce pain, improve mobility, and help you participate more comfortably in physical therapy and daily activities while avoiding or delaying surgery whenever medically appropriate.
An epidural steroid injection delivers anti-inflammatory medication into the epidural space surrounding the spinal cord and nerve roots. The injection usually contains a corticosteroid and may also include a local anesthetic.
The local anesthetic may provide temporary relief soon after the procedure, while the corticosteroid is intended to reduce inflammation around irritated spinal nerves over the following days.
Epidural injections may be performed in the:
Epidural steroid injections may be recommended for pain associated with:
An epidural injection does not repair every underlying spinal condition. Instead, it is designed to reduce inflammation and create an opportunity for improved movement, rehabilitation, and symptom control.
A lumbar epidural steroid injection targets the epidural space in the lower back. It is commonly used to treat pain that radiates from the lumbar spine into the buttocks, hips, or legs.
A lumbar epidural steroid injection targets the epidural space in the lower back. It is commonly used to treat pain that radiates from the lumbar spine into the buttocks, hips, or legs.
This procedure may be recommended for:
During the procedure, the physician advances a thin needle into the lumbar epidural space using fluoroscopic guidance. Contrast dye may be used to confirm the spread of medication before the injection is administered.
Some patients experience improvement within several days, while others may require one to two weeks to notice the full effect.
A cervical epidural steroid injection is performed in the neck to reduce inflammation affecting the cervical spinal nerves.
It may be used for:
Because the cervical spine contains delicate neurological and vascular structures, careful patient selection and image guidance are essential. Your physician will review your MRI or other imaging studies before recommending the procedure.
A caudal epidural steroid injection is administered through the sacral hiatus near the base of the spine. Medication then travels upward through the epidural space toward irritated nerves in the lower back.
A caudal approach may be considered for:
A lumbar transforaminal epidural steroid injection targets a specific nerve root as it exits the lower spine through a small opening called the neural foramen.
This highly targeted approach may be recommended for:
The injection is performed under fluoroscopic guidance. Contrast dye may be used to confirm the medication pattern and help avoid unintended placement.
A lumbar transforaminal injection may also provide diagnostic information by helping determine which nerve root is responsible for the patient’s symptoms.
A cervical transforaminal epidural steroid injection delivers medication near a specific cervical nerve root as it exits the neck.
This approach may be considered for selected patients with:
Cervical transforaminal injections require especially careful planning because of the nearby arteries, spinal cord, and nerve structures. They are not appropriate for every patient.
When this technique is considered, the physician evaluates the expected benefit, available alternatives, imaging findings, medication choice, and individual risk profile. A different epidural approach may be recommended when it offers a more appropriate safety-benefit balance.
An epidural blood patch is different from an epidural steroid injection. It is primarily used to treat a spinal headache caused by leakage of cerebrospinal fluid after a lumbar puncture, epidural procedure, spinal anesthesia, or an unintended dural puncture.
During the procedure, a small amount of the patient’s own blood is drawn from a vein and injected into the epidural space near the suspected leak. The blood forms a clot that helps seal the opening and restore normal cerebrospinal fluid pressure.
An epidural blood patch may be recommended for symptoms such as:
Many patients experience substantial improvement soon after the procedure, although response varies and additional evaluation may be needed if symptoms persist.
Medication is delivered into the posterior epidural space and may spread across a broader region. This approach may be useful when symptoms involve more than one nerve root.
Medication is delivered close to a specific nerve root as it exits the spine. This approach is generally more targeted and may also help identify which nerve is generating pain.
Your physician will determine the most appropriate approach based on your symptoms, imaging findings, anatomy, and medical history.
Most epidural injections are performed on an outpatient basis.
The typical process includes:
Epidural injections may offer several potential benefits.
Medication is delivered near the inflamed spinal nerve rather than circulating throughout the entire body as an oral medication would.
Corticosteroids may decrease swelling and chemical irritation surrounding compressed or inflamed nerve roots.
Reducing radiating pain may make walking, exercise, sleep, and everyday movement more manageable.
Pain relief may help patients participate more effectively in strengthening, stretching, and rehabilitation programs.
Epidural injections require no surgical incision and are typically performed on an outpatient basis.
For selected patients, epidural treatment may provide meaningful symptom relief without immediate surgery. However, it does not replace surgery when significant neurological compression or another urgent condition is present.
The duration of relief varies considerably. Some patients experience improvement for several weeks, while others may obtain relief for several months.
Results depend on factors such as:
Not every patient responds to epidural steroid injections, and repeated procedures are not automatically recommended. Your physician will reassess your progress before considering another injection.
Most patients return home the same day. Temporary soreness, pressure, numbness, or a brief increase in discomfort may occur after the procedure.
General aftercare may include:
Sedation policies vary. Patients who receive sedation generally need a responsible adult to drive them home.
Seek prompt medical attention for severe or worsening weakness, loss of bladder or bowel control, fever, severe headache, signs of infection, or other concerning symptoms.
Epidural injections are commonly performed and are generally well tolerated when properly indicated and carried out by an experienced physician using image guidance.
Potential risks include:
Risk varies depending on the spinal region, injection approach, medication, and individual medical history. Patients taking blood-thinning medication or those with infection, uncontrolled diabetes, bleeding disorders, or certain neurological conditions require additional evaluation.
Never stop a prescribed blood thinner unless the prescribing physician and procedural specialist have given coordinated instructions.
You may be considered for an epidural injection if you have:
Epidural injections may not be appropriate for patients with an active infection, certain bleeding risks, uncontrolled medical conditions, or symptoms requiring urgent surgical evaluation.
These warning signs may indicate a serious condition that should not be managed with a routine injection alone.
Facet joint injections are used to diagnose and treat pain originating from the small joints along the back of the spine.
A selective nerve root block targets an individual spinal nerve to help identify and temporarily reduce nerve-related pain.
Spinal cord stimulation may be considered for chronic nerve pain that has not responded adequately to less invasive treatments.
At TOPS Institute, we combine advanced interventional pain management with attentive, concierge-level care.
Patients choose our practice for:
An epidural steroid injection delivers anti-inflammatory medication into the epidural space around irritated spinal nerves. The medication may reduce inflammation and relieve radiating pain caused by conditions such as herniated discs, sciatica, radiculopathy, and spinal stenosis.
Lumbar epidural injections target nerves in the lower back and are commonly used for sciatica or radiating leg pain. Cervical epidural injections target nerves in the neck and may be used for pain, numbness, or tingling that radiates into the shoulder, arm, or hand.
A caudal epidural injection is administered through an opening near the base of the sacrum. It may be used when symptoms affect multiple lower-spine nerve roots or when prior lumbar surgery has altered the anatomy.
A transforaminal epidural injection delivers medication near a specific nerve root as it exits the spine. This targeted approach may be used for radiculopathy caused by foraminal stenosis or a herniated disc.
Candidates may include patients with sciatica, cervical or lumbar radiculopathy, herniated discs, spinal stenosis, or persistent radiating pain that has not improved with medication, activity modification, or physical therapy.
Cost varies based on the spinal region, injection technique, facility, imaging guidance, sedation, insurance coverage, and other clinical factors. Our office can help review scheduling and available coverage information before treatment.
Most patients feel pressure or brief discomfort rather than severe pain. Local anesthetic is used to numb the skin, and the procedure is performed carefully under image guidance.
Some patients notice improvement within a few days, while others may need one to two weeks. The local anesthetic may produce temporary early relief before the steroid begins working.
The injection itself may take only several minutes, but preparation, imaging, and post-procedure observation often make the complete appointment approximately 30 to 60 minutes.
The appropriate number depends on your diagnosis, response to previous injections, total steroid exposure, medical history, and physician judgment. Treatment should be individualized rather than based on an automatic injection schedule.
An epidural injection does not directly repair or remove a herniated disc. It may reduce nerve inflammation while the body heals and while the patient participates in rehabilitation.
An epidural blood patch uses a small amount of the patient’s own blood to help seal a cerebrospinal fluid leak that is causing a positional spinal headache. It is not a steroid injection.
Contact your physician for persistent or severe headache, fever, increasing redness or drainage, worsening weakness, loss of bladder or bowel control, or other unexpected neurological symptoms.
Persistent back pain, neck pain, sciatica, or radiating nerve pain can interfere with nearly every part of your life. A properly selected epidural injection may reduce inflammation, improve movement, and help you return to daily activity with greater comfort.
Contact TOPS Institute to schedule a comprehensive evaluation with an interventional pain management specialist in Los Angeles or Beverly Hills.
Leave a message or give us a call — we'll find a time that works for you.
640 South San Vicente Blvd., Suite 389, Los Angeles, CA 90048
Interventional pain management for Los Angeles & Beverly Hills — image-guided care that treats the source, not just the symptom.
© 2026 TOPS Institute · All rights reserved · Home
