Epidural steroid injection
A targeted injection of corticosteroid and local anaesthetic into the epidural space to settle nerve root inflammation that is causing sciatica or radicular limb pain.
Led by Dr Arul James (Consultant in Pain Medicine, GMC Specialist Register) at The Vesey, Sutton Coldfield. Self-pay and insurance accepted (BUPA, Vitality, AXA, WPA, Cigna, Aviva, Healix). Same-week appointments typical.
Who this procedure is for
- Sciatica with leg-dominant pain, numbness or pins-and-needles that has not responded to 4–6 weeks of physiotherapy and analgesia.
- MRI-confirmed lumbar or cervical disc bulge / herniation pressing on a nerve root.
- Radicular pain from foraminal stenosis where surgery is not yet appropriate or is being deferred.
- Acute flare of chronic radicular pain that is limiting work, sleep or rehab progress.
How the procedure is performed
Performed in our procedure suite under image guidance (fluoroscopy or ultrasound) by Dr Arul James. After local anaesthetic to the skin, a fine spinal needle is advanced into the epidural space. A small test dose of contrast confirms correct placement, then the steroid–local-anaesthetic mixture is delivered. The injection itself takes 15–20 minutes; the visit is typically 60–75 minutes including consent, monitoring and recovery.
Before, during and after
- Before: light meal allowed up to 2 hours before. Stop blood-thinners only on your prescribing doctor’s explicit advice — we will confirm the plan at consent. Bring a list of current medicines and your most recent imaging.
- During: you lie on your front, fully awake. You will feel pressure but the local anaesthetic settles most discomfort. Tell us at any point if you feel new leg pain or pins-and-needles.
- After: 30 minutes of monitored recovery, then home — bring someone to drive you for the first 24 hours. Expect mild local soreness for 24–48 hours and a possible “flare” before benefit starts. Pain relief usually develops over 3–10 days and peaks at 2–3 weeks.
Recovery and aftercare
Most patients return to office-based work the next day and to physiotherapy within 48–72 hours. We pair every injection with a structured rehab plan — the injection buys the window, the rehab keeps it.
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Risks and side effects
Common: short-lived increase in pain at the injection site, transient flush, mild blood-sugar rise in diabetic patients. Uncommon: temporary leg weakness, headache from dural puncture (< 1%). Rare: bleeding, infection, allergic reaction. Very rare but serious: nerve injury, epidural haematoma. Full written risk-and-benefit discussion at consent.
When this procedure is not appropriate
Active infection at the injection site, uncontrolled bleeding disorder, severe contrast allergy without alternative, pregnancy, or clear surgical indication (e.g. cauda equina, progressive motor weakness) — we will refer urgently.
Cost and pathway
Procedure fee published transparently — initial consultation £260, image-guided epidural steroid injection from £1,200 (single level) including consent, drugs, image guidance, recovery and the written report to your GP.
- Open 7 days including Sundays — 8am to 8pm, no weekend surcharge
- No GP referral required — book directly with Dr Arul James
- Sutton Coldfield location — serving Birmingham, Walsall, Tamworth, Lichfield and the West Midlands
- CQC-regulated — rated 4.88/5 on Doctify from 700+ verified reviews
View the full pain management pathway →
Sutton Coldfield · Birmingham · Walsall · Tamworth · Lichfield · West Midlands · Open 7 days 8am–8pm
Open 7 days · 8am–8pm · 0121 387 3727