Lumbar Epidural Injection
for Lower Back Pain & Sciatica
If your lower back pain has been going on for weeks — or the pain shoots down your leg every time you stand up — this injection may be the most direct non-surgical option you haven't tried yet. Quick outpatient procedure. You go home the same day.
Board Certified
Neurosurgeon
15+ Years
Experience
5000+
Procedures Performed
Get In Touch
Contact us today to schedule your consultation and take the first step toward relief.
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This form is intended for scheduling purposes only and is not a HIPAA-compliant form. Please avoid sharing any sensitive medical information. By submitting, you consent to being contacted using the information provided.
What Is a Lumbar Epidural Injection?
Most people have heard of epidurals — but in the context of spine care, a lumbar epidural is something a little different. It has nothing to do with surgery. It's a targeted injection that goes into the lower back to calm down an irritated nerve.
When a nerve in your spine gets compressed or inflamed — from a herniated disc, bone spur, or general wear — the area around it swells. That swelling is usually what's generating the pain, including any that travels into your leg. The injection delivers anti-inflammatory medication right to that spot, so it works where it actually needs to.
Here's how we explain it to patients who come into our Falls Church and Alexandria offices:
This is an injection in your lower back used to reduce inflammation around a nerve that may be causing back pain or pain traveling down your leg, such as sciatica.
The procedure is done using live X-ray guidance to ensure accurate placement of the medication. An anti-inflammatory is injected into the back to calm inflammation. It is not surgery and is a quick outpatient procedure. Patients go home the same day. You will not feel the injections as this is completed under LIGHT anesthesia. The goal is to relieve pain, improve function, and help you return to your normal daily activities.
30 Minutes
Same Day Procedure
No general anesthesia
2-6 Weeks Recovery
Who Does This Procedure Help?
A lumbar epidural works best when a nerve is the source of the problem. These are the diagnoses we see most often in patients who come to us for this treatment.
01
Sciatica
That burning, electric pain that starts in the lower back and runs down one leg — sometimes into the foot. Sciatica is nerve pain, and a lumbar epidural targets the inflammation driving it. Many patients see significant improvement after one injection.
02
Lumbar Radiculopathy
A pinched nerve root in the lower spine causes radiating pain, numbness, or weakness down the leg. The injection goes directly to where the nerve is being compressed and irritated — not just the area around it.
03
Herniated Disc
When a disc bulges or ruptures, it can push against a nearby nerve and create a lot of inflammation. The epidural injection calms that inflammation and gives the nerve room to recover without resorting to surgery.
04
Pinched Nerve in the Lower Back
Caused by a disc, bone spur, or narrowed canal — a compressed nerve in the lumbar spine often responds well to a properly placed epidural injection, especially when treated before symptoms become severe.
05
Degenerative Disc Disease
As discs age and lose height, they can start pressing on nearby nerves. Epidural injections help reduce the resulting pain and allow patients to stay active and make progress in physical therapy.
06
Spinal Stenosis
Narrowing of the spinal canal that squeezes the nerves running through it. A lumbar epidural is one of the most commonly used non-surgical treatments for stenosis, particularly for leg heaviness and pain when walking.
What a Lumbar Epidural Can Do for You
For patients who've already tried rest, medication, or physical therapy without real improvement — this is usually the next conversation worth having.
The Medication Goes Where the Problem Is
A pill travels through your whole body before reaching the inflamed area. An epidural puts the anti-inflammatory directly into the epidural space near the affected nerve — which is why it tends to work better for nerve-related back and leg pain.
Not Surgery
No cutting, no stitches, no hospital admission. If you've been putting off doing anything because you don't want surgery, this is worth knowing about. It's an outpatient injection and you're home the same day.
Short Procedure, Minimal Downtime
The injection itself takes under 30 minutes. Most patients are back to normal light activity by the next day. You don't need to take time off work for a surgical recovery — because this isn't surgery.
Placed with Live X-Ray Every Time
We use fluoroscopy — live X-ray imaging — to confirm the needle position before injecting anything. Not every practice does this. We do it in every case because accuracy directly affects how well the injection works.
Makes Physical Therapy Actually Possible
When your pain is severe, it's nearly impossible to do the rehab exercises that would actually help long-term. Bringing down the pain first creates the window you need to make real progress in therapy.
Comfortable from Start to Finish
Light anesthesia is used throughout. You're not asleep, but you won't feel the needle or the injection. Most patients tell us afterward it was easier than they expected.
What Makes Us Different
Patients come to us from Falls Church, Alexandria, and across Northern Virginia because we actually take time to figure out what's going on before recommending anything.
A Neurosurgeon Performing Your Injection
Dr. Buchholz is a fellowship-trained, board-certified neurosurgeon. When you come to us for a lumbar epidural, you're being treated by someone who operates on the spine — and understands it at a level most injection providers don't.
Live X-Ray on Every Single Case
We use fluoroscopy every time — not just for complex cases. The needle position is confirmed visually before any medication is released. Some practices skip this. We don't, because it directly affects outcomes.
We Look at You, Not Just the Scan
Imaging tells us part of the story. Your symptoms, history, and what's already been tried tell us the rest. We don't hand out the same plan to every patient who walks in with back pain.
Surgery Is Always the Last Resort
We start conservative and work up from there. If a lumbar epidural injection can give you the relief you need, that's the plan. Surgery only comes up when it's genuinely the right answer — not the fastest one.
Two Offices in Northern Virginia
Falls Church and Alexandria — both easy to get to without driving into DC. Most of our patients are in and out the same morning and back home before lunch.
Most Insurance Plans Accepted
We work with most major insurers and offer straightforward cash-pay pricing. Our team will help you understand what's covered before you commit to anything.
What Recovery Looks Like
Every patient responds a little differently, but here's what the typical week or two after the injection looks like.
Day of Procedure
Go Home and Take It Easy
You'll leave the office the same day. Have someone drive you — you can't drive yourself after light anesthesia. Some mild soreness at the injection site is normal. It usually passes within a day.
24–48 Hours
Back to Light Activity
Most patients feel well enough to go about their normal routine by the next day. Walking is fine. Just hold off on heavy lifting or anything strenuous for a few days while the medication settles.
3–7 Days
The Steroid Takes Effect
The corticosteroid usually reaches its full anti-inflammatory effect within the first week. A lot of patients notice a real shift in their pain level during this period — some sooner, some a few days later.
Weeks 2–8
Use the Window
The pain relief an injection creates is most valuable when you use it to get ahead of the problem — through physical therapy, stretching, and building strength in the muscles that support the spine. We'll help guide that process.
Weeks 2–8
Full Benefit & Rehabilitation
As pain subsides, your physician may recommend complementary physical therapy to build strength and address the underlying cause. The window of relief created by the injection is an ideal time to make progress in rehab.
Is This Right for You?
This injection works best when nerve inflammation is what's driving your symptoms. These are the situations where it tends to make the most sense:
Good Candidates for This Procedure
Lower back pain that travels down one or both legs
Burning or shooting pain consistent with sciatica
MRI or X-ray showing a herniated disc or spinal stenosis
Pain that hasn't improved with physical therapy or oral medication
Numbness or tingling in the leg or foot
Diagnosed with lumbar radiculopathy or a pinched nerve in the lower back
Want to try a non-surgical option before committing to anything more invasive
A Few Things We Check First
- Not recommended during pregnancy
- Blood thinners may need to be paused beforehand
- Uncontrolled diabetes requires closer follow-up after the injection
- Active infection near the injection site needs to clear up first
- We go through all of this at your consultation — nothing is assumed
Come in. We'll look at your imaging, hear your history, and give you a straight answer — whether that's this procedure or something else entirely.
Expert Spine Surgeon
Dr. Avery L. Buchholz is a board-certified neurosurgeon with fellowship training in complex spine surgery. With over 15 years of experience and 5,000+ procedures performed, he specializes in both minimally invasive and complex surgical techniques.
His expertise spans the full spectrum of spine care, from non-surgical interventions to advanced reconstructive procedures, always prioritizing patient safety and optimal outcomes.
Frequently Asked Questions
Get answers to common questions about our practice and procedures
How long will the pain relief last?
That depends on what's causing the pain and how your body responds. Some patients get a few months of significant relief from one injection. Others do a short series of two or three. We don't know upfront exactly how long it'll hold, which is why we track how you respond and adjust the plan accordingly. Using the relief window to do physical therapy tends to extend the benefit considerably.
Will I feel anything during the injection?
No. You receive light anesthesia before the procedure, so you won't feel the needle going in or the injection itself. You're not put to sleep — you stay aware and can talk to us — but there's no pain during the procedure. Most patients are genuinely surprised by how uneventful it is.
Is it safe?
Lumbar epidural steroid injections have been used for decades and have a solid safety track record when performed by an experienced physician. Using live fluoroscopy guidance — which we do in every case — adds precision, reducing risk. We go through the specifics with every patient at their consultation, including anything that might make it less suitable for them personally.
How many injections will I need?
Some people do well after one. Others need two or three spaced a few weeks apart. We don't decide that ahead of time — your response after the first injection tells us a lot about how to proceed. The goal is to get you better with as few injections as necessary, not to keep scheduling appointments.
Why do you use live X-ray? Is that standard?
Fluoroscopy lets us see exactly where the needle is in real time before we release any medication. It should be standard — but it isn't everywhere. Some practices do injections without any imaging, relying on surface landmarks to estimate placement. We use fluoroscopy on every case because getting the needle to the right spot is what determines whether the injection actually works.
Can I drive myself home?
No, you'll need a driver because light anesthesia is used. Please plan for that before your appointment. You should be fine to drive the following day again once it's fully cleared your system.
Will my insurance cover this?
Most major insurance plans do cover lumbar epidural steroid injections when there's a documented medical need. We accept most major plans and also have cash pay pricing available. Our team can help verify your coverage before your appointment so you know what to expect.
Is this considered surgery?
No. There are no incisions, no stitches, and no hospital stay. It's an outpatient injection done in our office. You walk in, have the procedure, wait a short time, and go home the same day. It's one of the key reasons patients who want to avoid surgery try this route first.
Our Locations
Serving patients across VA and the DC area
Falls Church, VA
6400 Arlington Blvd, Suite 710
Open
Alexandria, VA
6244A Little River Turnpike
Open
Richmond, VA
Address coming soon
Opening Soon
Charlottesville, VA
Address coming soon
Opening Soon
Washington, DC
Address coming soon
Opening Soon
Get In Touch
Contact us today to schedule your consultation and take the first step toward relief.
Address
6244 Little River Turnpike, Suite 101
Alexandria, VA 22312
Phone
FAX
Office Hours
Monday - Friday: 9:00 AM - 6:00 PM
Saturday: 9:00 AM - 6:00 PM
Sunday: Closed
This form is intended for scheduling purposes only and is not a HIPAA-compliant form. Please avoid sharing any sensitive medical information.
By submitting, you consent to being contacted using the information provided.
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