Steroid to the source. Precisely delivered.
An epidural steroid injection places a small volume of corticosteroid, combined with local anesthetic, into the epidural space of the spine — the anatomic zone surrounding the nerve roots. The goal is to reduce inflammation around a compressed or irritated nerve, providing meaningful pain relief that can last from weeks to several months.
Epidurals can be performed at four levels of the spine, depending on the source of pain: cervical (neck, for arm radicular symptoms), thoracic (mid-back), lumbar (lower back, for leg radicular symptoms — the most common), and caudal (sacral). Dr. Scott performs all four under ultrasound guidance in our AAAHC-accredited operating rooms.
The choice to use ultrasound rather than fluoroscopy is deliberate. Fluoroscopy exposes both patient and physician to X-ray radiation with every injection — and pain patients often need multiple injections over time. Ultrasound uses no ionizing radiation, offers real-time soft-tissue visualization, and produces equivalent placement accuracy for the levels we perform.
Who this procedure is designed for.
Epidural steroid injections address specific pain patterns. The consultation determines whether your presentation is a fit.
Lumbar radiculopathy (sciatica)
Leg pain following a nerve-root distribution, typically from disc herniation or foraminal stenosis compressing the nerve.
Cervical radiculopathy
Arm pain following a nerve-root distribution, often with numbness or weakness, from cervical disc pathology or foraminal narrowing.
Acute disc herniation
Recent-onset radicular pain following imaging-confirmed disc herniation.
Post-surgical inflammation
Persistent radicular symptoms following spine surgery, in select cases.
Not offered for spinal stenosis
The current pain literature does not support meaningful long-term efficacy of epidural steroids for spinal stenosis. Consistent with our practice of not offering procedures the evidence no longer supports, we discuss alternative approaches for these patients rather than delivering an injection unlikely to help.
Not for every back pain
Purely mechanical back pain without radicular symptoms often responds less well. The consultation is where the fit is determined.
Every pain-management patient at NCSS is seen personally by Dr. Rand Scott for the consultation — not delegated to a mid-level provider.
Three stages, one procedure.
An epidural injection is a same-day procedure performed in one of our operating rooms with sedation available if needed. The steps:
Ultrasound-guided approach
Real-time ultrasound imaging identifies the target anatomy, guides the needle placement, and confirms deposition location — without X-ray radiation.
Sterile technique
The injection site is prepped and draped as it would be for any surgical procedure. The needle is placed under continuous ultrasound visualization.
Precise deposition
A small volume of corticosteroid combined with local anesthetic is deposited in the epidural space adjacent to the target nerve root.
Confirmation
Ultrasound confirms the spread of injectate along the target anatomy before the needle is withdrawn.
Brief observation
You're monitored briefly in recovery to confirm you tolerated the procedure without complication.
The procedure itself typically takes 10–15 minutes. Total time in the facility, including preparation and recovery, is usually 60–90 minutes.
Two sites. One recovery.
Discharged after brief post-procedure observation. If sedation was used, someone must drive you home; without sedation, you may drive yourself.
Local injection-site soreness is common. Ice at the injection site helps. Occasionally patients notice a temporary increase in their usual pain (a 'flare') — this typically resolves within 24–48 hours.
The steroid begins to take effect. Most patients notice meaningful relief within 3–5 days, though onset can vary.
Duration of relief is variable. Some patients report benefit lasting several months; others need repeat injection at intervals.
Typically limited to three per calendar year at any given level, to minimize steroid-related side effects.
Most patients can return to normal activity the following day. No specific restrictions unless imposed by the underlying condition.
Follow-up with Dr. Scott occurs at Newport Pain Management for ongoing pain management coordination.
The medical director. Personally.
All interventional pain procedures at NCSS are performed by Dr. Rand Scott himself.
H. Rand Scott, MD
BOARD-CERTIFIED ANESTHESIOLOGIST · PAIN MANAGEMENT SUBSPECIALTYFounder of Newport Pain Management (1996) and Medical Director of NCSS. Ultrasound-guided technique, no fluoroscopy radiation.
Meet the medical director →The right starting point is a conversation.
Every epidural steroid injection consultation at NCSS begins with Dr. Scott personally — a careful review of your imaging, your pain pattern, and whether this procedure is the right fit.
Call (949) 644-8182Monday–Thursday, 8am–3pm · Friday by appointment only.
Related procedures.
Facet Joint Injections
For pain arising from the facet joints of the spine — often mistaken for radicular pain.
Learn more →Sacroiliac Joint Injections
For lower back and buttock pain from SI joint dysfunction — another common source often confused with radicular pain.
Learn more →Newport Pain Management
Dr. Scott's comprehensive pain practice adjacent to NCSS — for the broader diagnostic and treatment relationship.
Visit newportpain.com →