Anti-inflammatory medication placed into the space immediately around an irritated nerve, under live X-ray guidance, through a needle. No incision and nothing to recover from. For most people it is the first thing tried after physical therapy and medication, and for a great many of them it is the only thing needed — which is why it sits in front of almost every surgical pathway on this site.
They do not feel alike and they are not the same diagnosis. What they have in common is an inflamed nerve inside a space a needle can reach.
Lumbar transforaminal epidural steroid injectionThe animation shows the lumbar transforaminal route, which is the commonest. 1:52.
Both halves matter, and the second is the one people are rarely told about.
Which one is used depends on where the inflammation is, on what has been done to your spine before, and on what the live X-ray shows on the day.
These are general ranges from the interventional pain literature and from routine practice, not a guarantee for any individual case. Blood thinners have to be discussed before booking, and an injection is deferred if there is any active infection. If you develop a fever, worsening weakness, or new trouble controlling your bladder or bowels after an injection, that is not something to wait on — call the office, or go to the emergency department.
A good and lasting response means the inflammation was the problem and it has been treated. A good but short response tells us the level is right and the compression is mechanical, which is the conversation about whether an operation is worth it. No response at all is also information: it sends the search somewhere else, most often to the facet joints, to the vertebral body itself, or to the sacroiliac joint — each of which has a different treatment and its own page here.
The index lists every procedure in one place; the approach page explains how the choice between a tube and an open exposure actually gets made, and the conditions list names what comes through the clinic most often.