Sciatica Flare-Ups and Epidural Injections: A Medical Guide for Napa Patients

Understanding Epidural Steroid Injection Treatment Options in Napa, CA

By Dr. Jackie Weisbein, DO, Double Board Certified in Physical Medicine & Rehabilitation and Pain Medicine

Quick Insights

Epidural steroid injections are targeted interventional procedures that deliver anti-inflammatory medication directly to irritated spinal nerves to reduce sciatic leg pain. Clinical evidence shows these injections provide significant short-term relief for acute sciatica flare-ups, with effects typically strongest within the first 4-6 weeks. While not a permanent solution, epidural steroid injections can help patients regain mobility and participate in physical therapy when conservative treatments have been insufficient.

Key Takeaways

• ESIs may offer rapid relief from severe leg pain caused by sciatica.
• Benefits are generally strongest in the first weeks and then taper off.
• ESIs can provide a critical window of pain relief that enables patients to engage in physical therapy and other rehabilitation activities.
• Current research indicates surgery is more likely to provide lasting results than ESIs.

Why It Matters

When sciatica flares up, immediate relief is vital for staying active and minimizing frustration. Epidural steroid injection provides a non-surgical option for reducing pain in the short term, even if long-term effects are limited, helping you get back to what matters most.

Introduction

As a double board-certified pain specialist, I often get asked if an epidural steroid injection could finally bring “real” relief to those stuck in the spin cycle of sciatica flare-ups. In plain terms, an epidural steroid injection is a doctor-guided procedure designed to deliver anti-inflammatory medication directly to irritated nerves, aiming to decrease leg pain so you can get moving again—even when nothing else has helped.

I’ve performed over 100,000 advanced procedures as President of the Society of Women Innovators in Pain Management, and train other physicians nationwide to deliver the safest, most effective minimally invasive options. My approach at Napa Valley Orthopaedic Medical Group blends medicine, movement, and high-tech interventions for individualized care.

Recent systematic reviews, like this study on the short-term effects of epidural steroid injections for sciatica, suggest these injections can offer significant—though often temporary—leg pain relief.

If you’re frustrated, skeptical, or just desperate for short-term relief, you’re not alone. Let’s talk about what’s possible, even when you’ve already “tried everything.”

How Does an Epidural Steroid Injection Work?

When someone like Mark from Vallejo walks into my clinic, worn down by relentless leg pain, I know the last thing he wants is another “gimmick.” That’s why I always start by explaining exactly how an epidural steroid injection (ESI) works. In simple terms, I use live X-ray guidance to place a small needle near the irritated nerve root in your spine. Then, I inject a mix of anti-inflammatory steroid and numbing medicine right where the nerve is inflamed.

This isn’t a one-size-fits-all approach. For many patients, especially those who’ve tried everything else, the goal is to calm the nerve and reduce swelling so you can move again—sometimes within days. In my experience, the transforaminal approach (targeting the nerve from the side) often provides the most focused relief, which is supported by recent research.

As a pain management specialist who’s performed thousands of spine injections for patients, I’ve seen firsthand that even when you feel like nothing else has worked, a precisely-placed ESI can help restore your ability to move or sleep comfortably—at least for a while. Most people just want to get back to their lives, and when the nerve is the real problem, this targeted approach can offer real, if temporary, relief.

If you’re frustrated by pain that just won’t quit, you’re not alone. I’ve seen firsthand how even a single ESI can help someone get back to walking the dog or sitting through a family dinner. For more on the science behind this, check out this overview from Mayo Clinic.

Clinical Evidence: What Science Says About Epidural Injections for Sciatica

I know many of you—especially those who’ve bounced from one treatment to the next—want real answers, not hype. Studies suggest that epidural steroid injections can provide significant short-term relief for leg pain and improve function in people with sciatica, but the benefits tend to fade over time.

For example, Lena from Napa, who’s tried everything for her stubborn hip and back pain, often asks, “Will this actually last?” The honest answer is that while most patients feel better for a few weeks or months, ESIs are not a long-term fix. In fact, systematic reviews show that surgery is more likely to provide lasting results, but it comes with its own risks and recovery time.

When I review these studies, my focus is on what’s realistic for patients in day-to-day life—not just what’s measured in research settings. Most of my patients are looking for a window of relief: enough to get through a major event, kickstart physical therapy, or just break the cycle of sleepless nights. While I wish the benefits lasted longer, I’ve found that even temporary relief can be a turning point for people who feel stuck and hopeless.

In my practice, I always share these limitations up front. If you’re looking for a quick reset to get through a flare-up, an ESI may be a reasonable option. For a deeper dive into the evidence, I recommend this systematic review on ESIs for sciatica.

Who is a Good Candidate for ESI—And Who Isn’t?

I see a wide range of patients, all hoping for relief. But not everyone is the right fit for an epidural steroid injection. If your main issue is severe leg pain from a pinched nerve (often due to a herniated disc), and you haven’t found relief with physical therapy or medications, you might be a good candidate.

For someone like George from rural Sonoma County, who’s worried about safety at his age, I always review medical history carefully. ESIs are generally well-tolerated, but I avoid them in patients with certain infections, bleeding disorders, or uncontrolled diabetes. And if your pain is mostly in your back (not your leg), or you’ve already had multiple injections with little benefit, we may need to look at other options.

After working with patients from all over wine country, I’ve learned that matching the treatment to your exact pattern of pain is key. Many people ask me, “Isn’t it just going to be another dead end?” I always try to help you understand not just if you’re a candidate, but whether this particular injection is likely to help your specific problem and goals.

In my experience, the best results come when we match the right treatment to the right patient. For more on who should consider ESI, see this NICE guideline summary.

What Happens During the Procedure at Our Clinic?

I know the idea of a spinal injection can be intimidating—especially for folks like Lena, who’ve had disappointing experiences elsewhere. At Napa Valley Orthopaedic Medical Group, I perform every ESI myself, using real-time X-ray (fluoroscopy) for precision and safety. You’ll lie comfortably on your stomach, and I’ll numb the skin before guiding the needle to the exact spot.

The whole process usually takes less than 30 minutes, and most patients are up and walking within minutes. I always encourage questions and make sure you feel heard—no rushed, assembly-line care here. Many of my patients from American Canyon and Yountville tell me they appreciate the calm, boutique environment.

People often ask me if the procedure will be painful or if they’ll be able to drive home. In my practice, most patients describe the discomfort as manageable—like a pinch or pressure—followed by the relief of being able to stand up straighter or walk more easily. I never take your comfort for granted, and my goal is for you to feel safe and supported at every step.

If you’re curious about what to expect, the Providence Queen of the Valley Medical Center website has helpful information on outpatient spine procedures.

Benefits and Risks: What Patients Should Know

For people like Mark, who’ve tried “everything” and are skeptical about another shot, I’m always transparent about what ESIs can and can’t do. The main benefit is rapid, short-term relief from severe leg pain—sometimes enough to get you back to daily life or physical therapy. But studies indicate that these benefits usually taper off after a few weeks or months, and repeated injections may offer diminishing returns.

Risks are generally low but can include temporary numbness, infection, bleeding, or a spike in blood sugar. I’ve seen rare cases of headache or allergic reaction, but serious complications are uncommon when the procedure is done carefully. I always discuss these risks in detail, especially for older adults like George, who may have other health concerns.

As someone who’s double board-certified and performed advanced pain procedures for years, I know that every treatment is a balance—quick relief might help get you moving again, but it’s important to weigh those upsides against the reality that ESIs are rarely a long-term solution. I want all my patients to have realistic expectations, so you can make truly informed choices about your care.

If you want a balanced look at the pros and cons, I suggest reading this systematic review on nonsurgical sciatica treatments.

Alternatives if ESI Isn’t Enough

Sometimes, an epidural steroid injection just isn’t enough—especially for patients who’ve been through the wringer, like Mark or Lena. That’s when I talk about advanced options available right here in Napa. When standard treatments fail, established alternatives include spinal cord stimulation for nerve pain and the Minuteman procedure for spinal stabilization - both minimally invasive options with strong clinical outcomes..

I also believe in a holistic approach. Many patients benefit from physical therapy, ergonomic coaching, and lifestyle changes. Local programs may provide additional support.

As a physician who trains other doctors and leads national societies, I bring a full spectrum of options to my patients. Many people show up feeling like ESI was their last resort, but then discover there are effective, minimally invasive treatments that don’t require major surgery. In my experience, a custom blend of advanced interventions and whole-person care can help you reclaim activities you thought were lost for good.

If you’re feeling stuck, know that you’re not out of options. For a look at how advanced pain management is evolving, check out this overview of pain management at Adventist Health St. Helena.

Frequently Asked Questions About Epidural Steroid Injections

I get a lot of questions from patients—especially those who've been burned by 'miracle cures' before. Here are a few things I always clarify:

• How fast will I feel relief? Most people notice improvement within a few days, but it can take up to a week.
• How long does it last? Relief is usually strongest in the first month or two, then fades for most.
• Is it safe? When performed by an experienced physician, ESIs are generally safe, but no procedure is risk-free.
• What if it doesn’t work? We’ll talk about next steps, including advanced procedures or holistic care.
• What’s the experience like at your clinic? Expect personalized attention, clear communication, and a focus on your goals—not just your MRI.

I’ve seen firsthand how the right information can turn skepticism into hope. If you’re ready to explore your options, I’m here to help. For more answers, the American Academy of Orthopaedic Surgeons has a helpful patient guide.

Voices from Our Community

As someone who’s dedicated my career to restoring function and hope for people across Napa Valley, I know how much trust matters—especially when you’re considering advanced pain procedures like epidural steroid injections, spinal cord stimulation, or Intracept. My approach is always personal: every treatment is carefully tailored, and I strive to make each experience as comfortable as possible. It means a lot when members of our North Bay community share their honest feedback. One Google review shared:

Google Review Spotlight

Larry: my recent neck injection was nearly painless & the procedure was carefully administered. Read full review

Hearing this kind of feedback reinforces my commitment to a boutique, patient-centered model—one where advanced expertise and genuine care go hand in hand for Napa, St. Helena, and Sonoma residents.
See what our patients say

Conclusion

In summary, epidural steroid injections offer a targeted, evidence-based option for those struggling with sciatica flare-ups. Studies suggest these injections can provide meaningful short-term relief, especially when leg pain is keeping you from daily life, but it’s important to know the benefits often fade over time. My approach at Napa Valley Orthopaedic Medical Group is never one-size-fits-all—I blend advanced procedures, holistic care, and deep local experience to help you find the right solution.

As a double board-certified physician in Physical Medicine & Rehabilitation and Pain Medicine, and President of Women Innovators in Pain Management, I’m committed to honest answers and compassionate care. You don’t have to live in pain—there are real options. schedule your consultation today at www.drweisbein.com/contact-1.

This article is for educational purposes only and should not be used as a substitute for professional medical advice, diagnosis, or treatment. Always seek the advice of your physician or other qualified healthcare provider with any questions you may have regarding a medical condition or treatment options. Never disregard professional medical advice or delay in seeking it because of something you have read in this article.