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(Midline Epidural or Selective Block)

At the Pain Prevention Center, located in St. Louis, Missouri and Illinois corridor, Epidural steroid injections are performed on patients with low back pain and leg pain which is caused by inflammation or irritation of the nerve roots. This inflammation or irritation can be caused by arthritic degeneration of the spine or a disc herniation. Epidural steroid injections are helpful in treating inflammation in non-surgical patients, or can be used as a pre-surgical diagnostic tool to determine if a patient would benefit from a surgical procedure to decompress a herniated disc. In most cases, Epidural injections are done in a series of three every 2 weeks. Injections typically will have a mixture of two medications. One is lidocaine which is an anesthetic similar to what your dentist may have used for dental work. The primary function of lidocaine is to provide immediate feedback by “deadening” the painful tissue and thereby confirming a presumed diagnosis. The second medication is cortisone. Cortisone, naturally produced by the body, is concentrated in injections which help to reduce swelling and inflammation. The effects of lidocaine are immediate but may last only a few hours; the effects of cortisone may take 2-3 days or longer. The overall benefit of spinal injections may vary greatly from person to person and also with individuals repetitively over time. Please note that injections do not reverse arthritis, or change anatomy.

Preparing For An Epidural Steroid Injections:

  • Do not have a large breakfast. If you are diabetic you may need to eat a normal meal. You may eat a light meal.
  • Discontinue aspirin (or other blood thinners) at least 3 days before you injection. If you are on routine medications for heart or blood pressure, you should take your medication as usual the morning of your injection.
How Long Will The Injection Take?
  • The injection procedure itself only takes about 30 minutes, however you will need to block 1 to 2 hours from start to finish.
What Happens During An Epidural Steroid Injection?
  • Prior to the injection, you will be asked to sign a consent form. A nurse will check your vital signs and ask you what medications you are currently taking and if you are allergic to any medications.
  • In the x-ray room, the physician will cleanse the area with an antiseptic solution. He will numb the skin and begin the procedure. With the assistance of a C-arm fluoroscopic unit, the physician directs a needle through the spine into the epidural space. A local anesthetic and cortisone is injected through the needle into the space. Usually, the injections are performed in a series of three, spaced two weeks apart, to obtain the best results in the shortest period of time.
  • After your epidural steroid injections you will return to the recovery room for 30 minutes of observation. When you are released, you will need to have someone drive you home. We are located in St. Louis, Missouri and Illinois corridor in Chesterfield.
  • After your injection, it is recommended that you have “a lazy day” and preferably not return back to work.

A follow up appointment may be scheduled with your physician about 1 week following your injection to discuss the results.

Types of epidural steroid injections: "not the same as an epidural during pregnancy"

Selective Epidural Injection (SNRB/Transforminal Epidural Injection):

Midline Epidural Injection (Translaminlar Epidural Injection):

Caudal Epidural Injection:

Contact Us

13710 Olive Boulevard (Primary Office)
Chesterfield, MO 63017
Telephone: 314-469-PAIN (7246)

Fax: 314-469-7251
Exchange: 314-441-6965 (for after-hour Emergencies Only)

Monday thru Friday
8:30 AM – 4:30 PM