A lumbar herniated disc or spinal stenosis can cause pain by pressing on a nerve root. During an epidural injection, a special needle is guided to the affected area using medical imaging. A combination of medicines—steroid, local anaesthetic, hyaluronidase and hypertonic saline—is then injected. The aim is to reduce swelling and inflammation, release any adhesions and encourage the herniated tissue to shrink, thereby reducing pressure on the nerve. Lumbar epidural steroid injection is a reliable and highly effective non-surgical treatment.
No extensive preparation is required. The epidural steroid injection is performed under local anaesthesia and takes about 10–15 minutes. Patients are usually able to go home after approximately 30 minutes of observation and are advised to rest for two days. Side effects are very rare; systemic steroid effects are almost never seen, while infection, bleeding and nerve damage are extremely uncommon.
Our clinic uses three types of lumbar epidural injection.
Transforaminal Epidural Injection
This is a highly targeted injection delivered directly to the area of the herniated disc and compressed nerve. It is particularly successful for recently developed lumbar disc herniations.
Interlaminar Epidural Injection
This is an established, widely used technique. At our centre, we prefer it for spinal stenosis or lumbar disc herniations affecting more than one level.
Caudal Epidural Injection
We prefer this technique for lumbar disc herniation or spinal stenosis affecting the lower levels of the spine.
Appointments & practical information
How do I book an appointment?
You can send your appointment request via WhatsApp, by phone or through the contact form. Briefly describing your complaint and the times that suit you speeds things up; we respond as quickly as possible.
What should you bring to the consultation?
If available, bring your recent MRI and CT images, previous test and surgery reports, and a list of the medication you take regularly. This makes the assessment considerably easier.
What happens at the first consultation?
We listen to your complaints and history, perform a neurological examination and review your existing images together. Treatment options are then planned with you, taking your expectations and lifestyle into account.
Second opinion
If you have been diagnosed or advised to have surgery elsewhere, you can book an appointment for a second opinion with your existing images and reports.
Reach out for your questions and appointment requests. We reply as soon as possible.
An epidural injection is an interventional treatment method performed to relieve the edema, inflammation and pain around nerve roots that are compressed due to a herniated disc or spinal canal narrowing. A combination of medications is delivered into the area called the "epidural space", between the spinal cord membrane (dura mater) and the spinal canal, with the aim of relieving the nerve without the need for surgery.
How Is an Epidural Injection Performed?
The procedure is performed under operating-room conditions, in a sterile environment, with the patient lying face down. Guided by advanced imaging devices (fluoroscopy), the targeted herniation area is reached with special fine needles. After the correct position of the needle is confirmed with contrast material, the medication mixture is injected into the relevant area. It is a procedure that involves absolutely no stitches or incisions.
How Long Is the Hospital Stay After an Epidural Injection?
An epidural injection is not a surgical operation requiring hospitalization. After the procedure, our patients are discharged the same day, walking, following an observation period of about 2 hours. In this respect, it is one of the treatment methods offering the highest patient comfort.
What Are the Side Effects and Risks of an Epidural Injection?
When performed by a specialist neurosurgeon in a sterile environment, the risks are negligible. Rarely, temporary pain at the injection site, mild dizziness or short-term blood pressure changes related to the medications used may occur. Risks such as infection or bleeding are below 1% under professional standards.
How Many Days Does It Take for an Epidural Injection to Take Effect?
Some patients may feel immediate relief due to the local anesthetic in the medication. However, the actual therapeutic, edema-relieving effect usually begins within 24-72 hours. Maximum recovery and complete suppression of the pain is achieved within 10 days.
Does an Epidural Injection Eliminate the Herniation?
Rather than "dissolving" the herniation, this method shrinks it and eliminates the pressure it creates on the nerve, the chemical inflammation and the edema. When the pressure on the nerve is relieved, the pain subsides. The herniated tissue, with its edema dispersed and its size reduced, becomes easier for the body's defense mechanisms to absorb over time (regression).
What Is in an Epidural Injection?
The injection typically consists of two main components: a medication combination of a low-dose local anesthetic to stop the pain immediately, together with hyaluronidase, a steroid and hypertonic NaCl (saline). Because this mixture is delivered directly to the problem area, its systemic side effects are quite low.
What Should Be Considered After an Epidural Injection?
On the day of the procedure, you should rest at home. For the first 24 hours, heavy physical activity should be avoided, and movements that load the lower back — such as bending forward or lifting heavy loads — should not be performed. From the second day onward, you can return to normal daily activities; however, for full recovery you should follow your doctor's recommendations.
Which Department Performs Epidural Injections?
This procedure should be performed under operating-room conditions by Brain and Nerve Surgery (Neurosurgery) specialists who have full command of spinal anatomy and nerve root surgery.
What Are the Types of Epidural Injections?
There are three main types according to the application technique: "caudal" injections entering from the tailbone, "interlaminar" injections entering directly from the back of the spine, and "transforaminal" injections applied directly through the opening (canal) where the nerve exits. The most effective is the transforaminal injection. The most suitable technique is chosen by the surgeon based on the patient's MRI findings.
How Many Sessions of Epidural Injection Are Performed?
In most cases, a single session is sufficient to relieve the patient's pain and cause the herniation to regress. However, in certain special situations, up to 3 sessions may be performed.
Can an Epidural Injection Save You From Surgery?
Yes, the greatest success of this method is saving patients on the verge of surgery from an operation. About 80% of patients who have severe pain but no risk of paralysis are able to regain their health thanks to epidural injection, without ever lying on the operating table.
Does an Epidural Injection Provide a Definitive Solution?
When applied with the right patient selection and combined with lifestyle changes, it offers a "definitive and lasting" solution. If the patient watches their weight and strengthens their back muscles after the procedure, the risk of the herniation recurring is minimized.
Is There a Risk of Paralysis With an Epidural Injection?
Although such a fear exists among the public, in procedures performed under imaging guidance (fluoroscopy), the likelihood of the needle damaging the nerve or the spinal cord is much lower than in a surgical operation. In skilled hands, this risk is practically nonexistent.
Does an Epidural Injection Harm the Spinal Cord?
During the procedure, the needle is applied at levels far below where the spinal cord ends, and (as long as it stays within the epidural space) it does not even touch the spinal cord membrane. For this reason, damage to the spinal cord is not a medically expected occurrence.
Can an Epidural Injection Be Performed for Ruptured (Extruded) Herniated Discs?
Yes, absolutely. In fact, since the inflammation around the nerve is much more intense in ruptured (extruded) herniations, these injections can produce miraculous results. If there are no signs of paralysis, one of the first options for ruptured herniations is the epidural injection.
Is This Method Applied for Spinal Canal Narrowing (Spinal Stenosis)?
Yes. In patients with spinal canal narrowing, the nerves are compressed in a confined space and constant edema forms. By dispersing this edema, the epidural injection significantly improves the patient's comfort in daily life; in narrowing of the lumbar region it also increases the walking distance.
Is Pain Felt During the Epidural Injection Procedure?
Before the procedure, the area where the needle will enter is completely numbed with local anesthesia. The patient may only feel slight pressure; however, no serious pain or ache is felt. If needed for the patient's comfort, light sedation (a relaxing sleep-like state) can also be applied.
Why Is the Use of an Imaging Device (Fluoroscopy) Important During an Epidural Injection?
In "blind" injections performed without fluoroscopy, there is a high risk of the medication going to the wrong place. The imaging device ensures that the needle reaches, with millimetric precision, the exact point where the herniation is crushing the nerve, thereby guaranteeing the success and safety of the treatment.
What Are the Risks and Side Effects of an Epidural Injection?
The most common — but temporary — side effects are tenderness at the procedure site, mild numbness in the leg, and a short-lasting headache. These effects usually disappear on their own within 24 hours.
Is Hospitalization Required After an Epidural Injection?
No, hospitalization is not required. As it is an interventional pain treatment, our patients are discharged home the same day, walking, together with their companions, after 1-2 hours of monitoring in a recovery room.
Is It Normal for Pain to Increase After an Epidural Injection?
Very rarely, a temporary increase in pressure on the nerve may be felt as the volume of medication enters the confined area where the injection is given. Although this may cause the pain to increase slightly in the first 24 hours, once the medications begin to take effect, this sensation gives way to marked relief.
