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Epidural Steroid Injections

Villanueva Institute of Pain and Spine

Epidural Steroid Injections in Burbank, CA

Epidural steroid injections can help reduce pain caused by irritated or inflamed spinal nerves. If neck, back, arm, or leg pain is making it harder to sit, stand, walk, sleep, work, drive, or participate in daily life, an epidural steroid injection may be one option to help calm inflammation and make movement more manageable.

I am Dr. John Villanueva, double board-certified in PM&R and interventional pain management at the Villanueva Institute of Pain and Spine (VIPS). Before recommending an injection, I review your symptoms, imaging, exam findings, prior treatments, and daily limitations to develop an appropriate treatment plan.

Many patients come to VIPS after trying medication, physical therapy, rest, or prior procedures without enough relief. Some have been told they have sciatica, a herniated disc, spinal stenosis, a pinched nerve, or radiculopathy, but still do not fully understand what that means for their care. My team and I are here to listen closely, explain your options clearly, and help you feel more confident about the next step.

If you are looking for epidural steroid injections in Burbank, CA, call VIPS at (818) 669-8895 or conveniently request an appointment online. We are located in Burbank and proudly serve patients visiting from Glendale, Pasadena, Van Nuys, Toluca Lake, Studio City, Sherman Oaks, North Hollywood, Sun Valley, La Cañada, La Crescenta, Los Feliz, Atwater Village, Silver Lake, Echo Park, and communities throughout the San Fernando Valley and greater Los Angeles area.

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What Are Epidural Steroid Injections?

Epidural steroid injections are image-guided injections that deliver anti-inflammatory medication into the epidural space, the area around the spinal nerves. The medication is intended to reduce irritation around inflamed nerve roots that may be contributing to neck, back, arm, or leg pain.

These injections are commonly considered when pain is related to nerve inflammation or compression. Depending on the source of your symptoms, they may be used for cervical, thoracic, or lumbar spine conditions.

An epidural steroid injection does not remove a herniated disc, widen the spinal canal, or permanently change the structure of the spine. Instead, it may reduce inflammation enough to improve pain, mobility, sleep, activity tolerance, and participation in rehabilitation.

How Do Epidural Steroid Injections Work?

When a spinal nerve becomes irritated, compressed, or inflamed, pain may travel from the spine into another area of the body. A pinched nerve in the neck can cause pain, numbness, tingling, or weakness in the shoulder, arm, or hand. A pinched nerve in the lower back can cause pain that travels into the buttocks, hip, leg, or foot.

During an epidural steroid injection, medication is delivered near the irritated nerve root or inflamed area. The steroid medication can help reduce inflammation, while a local anesthetic may provide temporary numbing or diagnostic information.

Your response can also help guide future care. If the injection provides meaningful relief, it may confirm that nerve inflammation is part of your pain pattern. If it does not help, that information can still be useful, as it may point us toward a different pain source or treatment approach.

What Conditions Can Epidural Steroid Injections Help?

Epidural steroid injections may be appropriate when pain is related to irritated spinal nerves or inflammation near the nerve roots. Conditions that may benefit from epidural steroid injections include:

Epidural steroid injections are not designed for every type of back or neck pain. For example, pain coming mainly from facet joints, sacroiliac joints, muscles, or arthritic joints may respond better to another type of treatment. That is why I take time to understand your pain pattern before recommending a procedure.

Cervical, Thoracic, and Lumbar Epidural Steroid Injections

Epidural steroid injections may be performed in different areas of the spine depending on where symptoms begin.

  • Cervical Epidural Steroid Injections: A cervical epidural steroid injection targets the neck region. This may be considered when inflammation or compression in the cervical spine causes neck pain that travels into the shoulder, arm, or hand. Symptoms may include numbness, tingling, burning, weakness, or electric pain.
  • Thoracic Epidural Steroid Injections: A thoracic epidural steroid injection targets the mid-back region. Thoracic nerve irritation is less common than cervical or lumbar radiculopathy, but it may cause pain around the ribs, chest wall, or mid-back depending on the affected nerve.
  • Lumbar Epidural Steroid Injections: A lumbar epidural steroid injection targets the low back region. This is often considered for sciatica, lumbar radiculopathy, herniated discs, spinal stenosis, or pain traveling from the low back into the buttock, hip, leg, or foot.


The location of the injection should match your symptoms, imaging, and exam findings.

Types of Epidural Steroid Injections

There are several approaches to epidural steroid injections. The right approach depends on your anatomy, diagnosis, imaging, surgical history, and pain pattern.

  • Interlaminar Epidural Steroid Injection: An interlaminar epidural steroid injection places medication into the epidural space from the back of the spine. This approach may be used when medication needs to spread more broadly within the epidural space.
  • Transforaminal Epidural Steroid Injection: A transforaminal epidural steroid injection places medication near the area where a spinal nerve exits the spine. This approach may be considered when symptoms follow a specific nerve root pattern, such as pain traveling down one leg or one arm.
  • Caudal Epidural Steroid Injection: A caudal epidural steroid injection accesses the epidural space through the sacral region near the bottom of the spine. This may be considered for certain low back and leg pain patterns, including some patients with prior lumbar surgery or anatomy that makes another approach less appropriate.

Good Candidates for Epidural Steroid Injections

You may be a good candidate for an epidural steroid injection if your symptoms, physical exam, and imaging suggest that spinal nerve inflammation is contributing to your pain.

Suitable candidates often have pain that travels from the neck into the arm or from the low back into the leg. Some patients also experience numbness, tingling, burning, weakness, or pain that worsens with certain positions.

Epidural steroid injections may be considered when symptoms have not improved enough with conservative care, including rest, physical therapy, activity modification, or medication. They may also be used when pain is severe enough to interfere with rehabilitation or daily function.

The best candidates understand that an epidural steroid injection is one part of a larger care plan. Some patients need one targeted injection. Others may need medication review, physical therapy guidance, EMG/NCS testing, follow-up care, or a different procedure if the pain source is not primarily nerve related.

How I Evaluate You Before Recommending an Epidural Steroid Injection

Before recommending an epidural steroid injection, I want to understand where the pain is coming from and how it is affecting your life. Two patients may both have low back pain, but one may have sciatica from a herniated disc, another may have spinal stenosis, another may have facet joint pain, and another may need a surgical opinion.

During your consultation, I may:

  • Listen to your history and how pain affects your daily life
  • Review prior records, medications, procedures, and surgical history
  • Personally review imaging such as X-rays, MRIs, or CT scans whenever available
  • Perform a physical and neurological examination
  • Recommend EMG/NCS testing when nerve or muscle function needs closer evaluation
  • Explain which pain sources seem most likely and why
  • Discuss whether an image-guided epidural steroid injection may be appropriate


Written radiology reports are helpful, but the images themselves can show details that matter. Whenever possible, I prefer to review the actual imaging so I can better understand your anatomy and choose the safest, most appropriate approach.

Epidural Steroid Injections and Your Broader Treatment Plan

Epidural steroid injections often work best as part of a larger plan. Depending on your condition, that plan may include physical therapy, rehabilitation planning, medication management, activity changes, EMG/NCS testing, or coordination with another specialist.

If your pain is coming from irritated spinal nerves, an epidural steroid injection may be useful. If your pain is coming from facet joints, sacroiliac joints, muscles, peripheral nerves, or another source, a different approach may make more sense.

At VIPS, I look at your symptoms, exam, imaging, medical history, prior treatments, and goals together. If an image-guided epidural steroid injection may help, I will explain why. If your imaging or neurological findings suggest that surgery should be considered, I will tell you directly.

Why Choose VIPS for Epidural Steroid Injections?

At VIPS, epidural steroid injections are considered when your symptoms, exam, and imaging suggest that irritated spinal nerves may be part of the pain pattern. The decision should be specific, explainable, and connected to what you are experiencing in daily life.

When you choose VIPS, you can expect:

I am double board-certified in PM&R and interventional pain management, which allows me to evaluate spine pain from both a functional and procedural perspective. My PM&R training helps me understand how pain affects movement, strength, daily activity, and rehabilitation, while my interventional pain training allows me to perform targeted procedures when appropriate. In addition to being double-board certified, I am a Certified Life Care Planner, with advanced specialized training in assessing the long-term medical, rehabilitation, and future care needs of individuals with complex injuries and disabilities. This additional expertise further strengthens my work as a medical-legal consultant and expert medical witness.

I review your symptoms, physical exam, imaging, medical history, and prior treatments before deciding whether an epidural steroid injection is likely to help.

I use fluoroscopy or ultrasound guidance when appropriate for targeted procedures rather than blind injections. Image guidance helps confirm placement and supports a more controlled procedure.

Medication type, concentration, volume, frequency, and approach should not be automatic. I tailor those decisions based on your diagnosis, anatomy, prior treatment response, and overall care plan.

If an epidural steroid injection makes sense, I will explain why. If another treatment, such as a nerve block, medial branch block, facet joint injection, radiofrequency ablation, medication management, rehabilitation, or surgery, is more appropriate, I will tell you directly.

Many patients come to VIPS after feeling rushed, dismissed, or unsure where to turn next. My team and I want you to feel heard, informed, and comfortable asking questions before any procedure is performed.

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What Happens During an Epidural Steroid Injection?

Before the procedure, I review your symptoms, imaging, medical history, and treatment plan, so you understand why the injection is being recommended. My team will also review preparation instructions, medication guidance, and what to expect during your visit.

During the procedure, our team will position you so that I can safely access the targeted area. Your skin will be cleaned, and a local anesthetic may be used to numb the area. I then use imaging guidance to precisely direct the needle to the intended location.

Once the needle is positioned, medication is injected into the epidural space. The procedure itself is usually completed fairly quickly, though your full visit may take longer due to preparation, monitoring, and discharge instructions.

After the injection, you may be monitored for a short time before going home. I will give you instructions about activities, medications, and what symptoms to watch for after the procedure.

What Should You Expect After an Epidural Steroid Injection?

Some patients notice temporary relief soon after the injection, especially if a local anesthetic is used. The steroid medication may take longer to have its full effect, and improvement may develop over several days.

You may have mild soreness near the injection site for a short time. Some patients experience temporary changes in pain before symptoms begin to improve. I will explain what is expected, what should be monitored, and when to contact the office.

Your response matters. If the injection helps, it may support the idea that spinal nerve inflammation is contributing to your pain. If it does not help, we may need to reconsider the source of the pain, review your imaging again, or discuss other treatment options.

How Long Do Epidural Steroid Injection Results Last?

The duration of relief from an epidural steroid injection varies. Some patients experience short-term improvement, while others have relief that lasts for weeks or months. Results depend on your diagnosis, anatomy, extent of inflammation, underlying structural condition, and how your body responds.

For some patients, an epidural steroid injection helps reduce pain enough to participate more comfortably in physical therapy or daily activities. For others, it provides diagnostic information or helps determine whether a different treatment should be considered.

I will help you understand realistic expectations based on your condition. Instead of promising a specific outcome, I use the information we have to make thoughtful decisions about your care.

Epidural Steroid Injection FAQs

If neck, back, arm, or leg pain is limiting how you move, work, sleep, drive, exercise, or participate in daily life, an epidural steroid injection may help reduce nerve-related inflammation and clarify the next step in your care.

To schedule an epidural steroid injection consultation in Burbank, CA, call (818) 669-8895 or contact VIPS online today. The right care may help you spend less of each day planning around pain and more of it living with comfort, confidence, and peace of mind.

Epidural steroid injections are most often used for pain caused by inflamed or irritated spinal nerves. This may include sciatica, cervical radiculopathy, lumbar radiculopathy, herniated discs, spinal stenosis, degenerative disc disease, foraminal stenosis, and certain cases of pain after spine surgery.

They are related, but they are not the same. An epidural steroid injection places medication into the epidural space around irritated spinal nerves. A nerve block targets a specific nerve or group of nerves. The right option depends on your symptoms, imaging, exam findings, and suspected pain source.

Yes, an epidural steroid injection may help certain patients with sciatica when the pain is caused by irritation or inflammation around a spinal nerve in the lower back. Sciatica often causes pain that travels from the lower back or buttocks into the leg, and may also involve numbness, tingling, burning, or weakness.

They may help when neck pain is due to cervical nerve irritation, especially when the pain radiates into the shoulder, arm, or hand. If your neck pain is mainly caused by facet joints, muscle tension, or another source, a different treatment may be more appropriate.

Yes. At VIPS, epidural steroid injections are performed with imaging guidance when appropriate. Fluoroscopy, which provides live X-ray guidance, helps ensure medication is delivered to the intended area.

Some patients feel temporary relief soon after the injection because of the local anesthetic. Steroid medication may take longer to work, and improvement may develop over several days. I will explain what to track after the injection, so we can interpret your response appropriately.

Results vary. Some patients have relief for several weeks, while others may have improvement for months. The duration depends on your diagnosis, the severity of nerve irritation, the underlying structural condition, and your body’s response to treatment.

Some patients need only one injection, while others may need additional care, depending on their response. The number of injections depends on your diagnosis, symptoms, imaging, medical history, insurance requirements, and overall treatment plan.

Sometimes. Epidural steroid injections may help reduce pain and improve function without surgery when a nonsurgical plan is medically appropriate. However, they are not a replacement for surgery when surgery is truly the better option. If your imaging, neurological exam, or symptoms suggest that a surgical opinion should be considered, I will tell you directly.

Most patients tolerate the procedure well. You may feel pressure, brief discomfort, or temporary soreness near the injection site. A local anesthetic may be used to help numb the area, and my team will explain what to expect before the procedure begins.

If an epidural steroid injection does not provide meaningful relief, that information is still useful. It may suggest that the pain is coming from another source, that a different injection approach should be considered, or that additional evaluation is needed. I will review your response with you and discuss the next appropriate step.

The cost of an epidural steroid injection in Burbank can vary depending on the spinal region treated, the injection approach, the procedure setting, and your insurance benefits. During your consultation, my team can help you understand what information may be needed for scheduling, authorization, and cost review.

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