How is the epidural steroid injection performed? Before the epidural steroid injection An epidural steroid injection usually takes between 15 and 30 minutes. The patient lies flat on an x-ray table on their abdomen. Prior to the epidural injection, the skin is numbed with lidocaine, which is similar to the novocaine that the dentist uses (a "local" anesthetic). Many types of physicians can be qualified to perform an epidural steroid injection, including an anesthesiologist, radiologist, neurologist, physiatrist and surgeon. Using fluoroscopy (live x-ray) for guidance, the physician directs a needle toward the epidural space. Fluoroscopy is considered important in guiding the needle into the epidural space, as controlled studies have found that medication is misplaced in 13% to 34% of epidural steroid injections that are done without fluoroscopy. During and after the epidural steroid injection Once the needle is in the exact position, the epidural steroid solution is injected. Following the injection, the patient is usually monitored for 15 to 20 minutes before being discharged to go home. Sedation is available for patient anxiety and comfort. However, sedatives are rarely necessary, as the epidural steroid injection procedure is usually not uncomfortable. If a sedative is used, the patient will need to be monitored for a longer period following the injection. Patients are usually asked to rest on the day of the epidural steroid injection. Normal activities (those that were done the week prior to the epidural injection) may typically be resumed the following day.