Dr. Jordan Sudberg Explains Epidural Steroid Injections: What They Are and When They’re Used for Pain Relief
Chronic back pain can be life-altering, affecting everything from sleep and work performance to mental health and quality of life. For those who’ve tried physical therapy, medications, and lifestyle changes without adequate relief, there’s another minimally invasive option that often provides meaningful results: the epidural steroid injection (ESI).
But what exactly is an epidural steroid injection? How does it work, and who is a good candidate for this treatment?
We sat down with Dr. Jordan Sudberg, a nationally recognized pain management specialist, to unpack everything you need to know about epidural steroid injections. With years of experience helping patients regain comfort and mobility, Dr. Sudberg provides insight into how this procedure works and why it’s a trusted tool in the field of interventional pain medicine.
What Is an Epidural Steroid Injection?
An epidural steroid injection is a minimally invasive procedure that delivers powerful anti-inflammatory medication—typically a corticosteroid—directly into the epidural space of the spine. This space surrounds the spinal cord and nerve roots and is often the site of inflammation causing back, neck, or leg pain.
“The goal is to reduce inflammation and relieve pressure on irritated nerves,” explains Dr. Sudberg. “It doesn’t cure the underlying issue, but it often provides significant pain relief that allows patients to pursue other forms of rehabilitation.”
Conditions Treated with Epidural Steroid Injections
Epidural steroid injections are not a one-size-fits-all solution, but they can be highly effective for specific conditions involving spinal nerve inflammation. According to Dr. Jordan Sudberg, these include:
- Herniated discs
- Degenerative disc disease
- Spinal stenosis
- Sciatica (lumbar radiculopathy)
- Cervical radiculopathy
- Post-surgical spine pain
- Spondylolisthesis
Many of these conditions involve nerve roots that become compressed or irritated by inflamed tissue, bulging discs, or spinal joint changes. By targeting these areas directly with steroids, swelling is reduced, and nerve signals become less reactive.
How Does an Epidural Steroid Injection Work?
The steroid used in an ESI reduces the production of inflammatory chemicals and decreases nerve sensitivity in the affected area. While it doesn’t reverse structural damage like a bulging disc, it can break the pain-inflammation-pain cycle long enough for physical healing to begin.
“The anti-inflammatory effect of the steroid allows the nerve root to calm down,” says Dr. Sudberg. “This often gives the patient a window of opportunity to regain strength, mobility, and function through physical therapy.”
The Procedure: What to Expect
Dr. Jordan Sudberg ensures patients understand exactly what happens during the injection process. Here’s a typical outline:
1. Preparation
The patient is positioned either on their stomach or side. The procedure is performed in a sterile environment, often under fluoroscopy (real-time X-ray guidance) to ensure accuracy.
2. Local Anesthesia
A local anesthetic numbs the skin and surrounding tissue where the injection will be placed. Some patients also receive a mild sedative.
3. Needle Insertion
Using imaging guidance, Dr. Sudberg carefully inserts a thin needle into the epidural space.
4. Injection
The corticosteroid—sometimes mixed with a local anesthetic—is slowly injected. The entire process typically takes 15–30 minutes.
5. Recovery
Patients are monitored for a short period afterward and usually discharged the same day. Many return to normal activities within 24–48 hours.
“Because it’s minimally invasive, downtime is limited,” says Dr. Sudberg. “Most patients feel some relief within a few days, though full benefit may take up to two weeks.”
How Effective Are Epidural Steroid Injections?
Effectiveness varies depending on the underlying condition, patient health, and adherence to complementary treatments like physical therapy. In many cases, an ESI provides weeks to months of relief, allowing patients to reduce their reliance on pain medications or postpone surgery.
“Some patients feel a 70–90% reduction in pain,” Dr. Sudberg explains. “Others may need a series of injections over time to maintain results.”
ESIs are especially valuable for managing flare-ups of chronic pain or during acute phases when inflammation is at its peak.
Risks and Side Effects
While generally safe, Dr. Jordan Sudberg notes that epidural steroid injections do carry some risks, particularly if overused. Common side effects include:
- Temporary increase in pain after injection
- Headache
- Facial flushing
- Elevated blood sugar (especially in diabetics)
- Insomnia or mood changes
- Rare complications like infection, nerve injury, or bleeding
To minimize risks, most physicians limit the number of ESIs to 3 per year, spaced several months apart.
“Steroid exposure must be carefully managed,” cautions Dr. Sudberg. “That’s why we combine injections with long-term strategies like exercise and ergonomic education.”
Who Is a Good Candidate?
Not everyone with back pain needs an epidural injection. Dr. Sudberg recommends a thorough evaluation, including a full medical history, physical exam, and imaging (MRI or CT scan), before deciding on ESI as a treatment.
Good candidates typically:
- Have nerve-related pain that radiates to arms or legs
- Have not improved with medications and conservative care
- Are not ready for or want to avoid surgery
- Do not have infections, bleeding disorders, or uncontrolled diabetes
Alternatives to Consider
While ESIs can be powerful tools, they’re most effective when part of a comprehensive pain management plan. Dr. Jordan Sudberg often incorporates:
- Physical therapy
- Non-opioid medications
- Chiropractic care
- Acupuncture
- Lifestyle coaching
- Radiofrequency ablation or spinal cord stimulation for more persistent cases
“It’s about combining approaches to build a foundation for long-term recovery,” Dr. Sudberg emphasizes.
Final Thoughts: Relief Without Major Surgery
Epidural steroid injections represent a significant advancement in treating spine-related pain without the risks and recovery time of surgery. They allow patients to stay active, reduce inflammation, and regain quality of life—often when other methods haven’t worked.
Dr. Jordan Sudberg encourages anyone dealing with persistent back, neck, or nerve pain to consult with a pain management specialist to determine if they are a candidate for ESI.
“Pain is personal, but so is relief,” Dr. Sudberg concludes. “With careful diagnosis and targeted therapy like epidural steroid injections, we can help patients find real, lasting relief—without needing to go under the knife.”
