Epidural Steroid Injections in Castle Rock
What is an Epidural Steroid Injection?
An epidural steroid injection (ESI) delivers anti-inflammatory medication into the epidural space - the area surrounding the spinal cord and nerve roots. The steroid reduces swelling and irritation of compressed nerves, which can relieve pain in the neck, back, arms, or legs. A local anesthetic is included in the injection to provide immediate temporary relief while the steroid takes effect over the following days.
Epidural steroid injections are one of the most commonly performed procedures in interventional pain management. They are not a permanent fix, but for many patients they provide enough relief to increase activity, participate in physical therapy, and avoid or delay surgery.
What Conditions Are Treated with Epidural Steroid Injections?
ESIs work best for pain caused by nerve irritation or compression. Common conditions include:
Herniated or bulging discs pressing on a nerve
Sciatica (pain radiating down the leg from a pinched nerve in the lower back)
Spinal stenosis (narrowing of the spinal canal)
Cervical radiculopathy (pinched nerves in the neck causing arm pain, numbness, or tingling)
Degenerative disc disease with nerve involvement
Bone spurs compressing spinal nerves
Post-surgical nerve pain or scar tissue irritation
Types of Epidural Steroid Injections
There are three types of epidurals. Dr. Carrera's team recommends the specific type based on your condition, imaging, and the location of your pain.
Transforaminal Epidural Steroid Injection (TFESI)
The needle is placed alongside a specific nerve root where it exits the spine through the foramen (the bony opening). This is the most targeted type of epidural and is particularly effective for sciatica, single-level disc herniations, and situations where identifying the exact nerve responsible for your pain is important. Because it targets one nerve at a time, the transforaminal approach also has diagnostic value - if the injection relieves your pain, it confirms which nerve is the source.
Learn more on the transforaminal epidural injection page.
Interlaminar Epidural Steroid Injection (ILESI)
The needle enters the epidural space from the back of the spine, between two vertebrae. The medication spreads more broadly across multiple nerve roots, which makes this approach useful for spinal stenosis, bilateral symptoms (pain on both sides), or conditions affecting several levels of the spine.
Learn more on the interlaminar epidural injection page.
Caudal Epidural Steroid Injection
The needle enters at the base of the spine through the sacral hiatus, a small natural opening in the tailbone. The medication travels upward into the lower lumbar epidural space. Caudal epidurals are commonly used for patients with lower back pain affecting multiple nerve roots, patients who have had previous lumbar spine surgery (where scar tissue may make other approaches more difficult), and patients with conditions like lumbar stenosis at multiple levels.
Learn more on the caudal epidural injection page.
Which Type of Epidural Is Right for Me?
The choice depends on your anatomy, your symptoms, and what your imaging shows. In general:
If your pain is on one side and follows a specific nerve pattern (like sciatica down one leg from a disc herniation), a transforaminal epidural is usually the best fit.
If your pain is on both sides, involves multiple levels, or is caused by stenosis, an interlaminar or caudal epidural may provide better coverage.
If you have had previous lumbar spine surgery, a caudal epidural may be preferred because it enters below the surgical area and avoids scar tissue.
Dr. Carrera's team evaluates your imaging and symptoms to determine the best approach. In some cases, multiple types of epidurals may be used over the course of treatment.
How Quickly Can I Get an Epidural?
At many pain practices in the Denver and Colorado Springs area, patients wait 2 to 3 months for an initial evaluation and then another several weeks for the procedure itself. Dr. Carrera's team works on a different timeline. Most epidural injections are scheduled within one week of the initial consultation. For patients referred by a surgeon or another provider specifically for an injection, the team can often schedule the procedure within one week of the referral.
Does Insurance Cover Epidural Steroid Injections?
Most insurance plans, including Medicare, Medicaid, and commercial insurers, cover epidural steroid injections when certain criteria are met. These typically include pain lasting at least six weeks and failure of conservative treatments such as physical therapy and medications. Some plans allow injections sooner. Prior authorization may be required, and the team handles this process in-house.
Find the Right Approach for Your Pain
Not sure which type of epidural is right for you? Dr. Carrera's team evaluates your symptoms, imaging, and history to recommend the most targeted approach for your specific condition.