Concierge pain medicine · London
Private epidural steroid injection in London, by a consultant pain specialist.
A properly image-guided epidural steroid injection for sciatica, cervical nerve root pain or chronic radicular pain — the right approach for your MRI, delivered in a proper day-case theatre.
Why patients choose us
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A consultant pain specialist, in theatre
Not a landmark blind injection in a treatment room. A named pain consultant, fluoroscopy or CT guidance, and a proper day-case theatre.
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The right injection for the right pain
Interlaminar, transforaminal, caudal — the choice depends on your MRI and your pain pattern. We match one to the other before we book.
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Independent, and free
We are paid by no clinic, so the recommendation is impartial and costs you nothing.
Indicative pricing
What a private epidural steroid injection costs in London.
Indicative ranges across our partner clinics. Send the details and we quote firm figures across two or three options.
In short
A lumbar interlaminar ESI in our network: £900–£1,600, home the same day.
| Procedure | Indicative range | Typical duration | Recovery |
|---|---|---|---|
| Interlaminar lumbar ESI (fluoroscopy) | £900–£1,600 | 15–30 min | Same visit |
| Transforaminal ESI (single nerve root) | £1,100–£1,900 | 20–30 min | Same visit |
| Caudal ESI (via sacral hiatus) | £850–£1,500 | 15–25 min | Same visit |
| Cervical transforaminal (non-particulate) | £1,400–£2,400 | 20–30 min | Same visit |
| ESI with light IV sedation | +£400–£800 | Half-day | Same visit |
| Pain consultation only | £200–£400 | 30 min | Same visit |
Prices vary by clinic, by which pain consultant does the case, by the type of injection and image guidance chosen, and by whether sedation is added on the day. We come back with a firm quote within one working day.
The problem
The right injection, the right level, the right steroid.
A generic “epidural for back pain” is often the wrong question. The right question is which nerve, which approach, and which steroid — and whether an injection is the right step at all.
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Not sure it is needed?
For axial back pain without radicular symptoms, NICE NG59 does not recommend an epidural. We tell you before you commit.
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Worried about the risks?
Image guidance, non-particulate steroid where indicated, and an anaesthetic team who plan around your anticoagulation and diabetes.
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Want it done properly?
A named consultant pain specialist, fluoroscopy or CT, and an operation note you can actually read.
The journey
From enquiry to pain relief — what happens, in order.
One clinician from first message to review — including the recovery window.
Phase 1 · Before your procedure
Concierge, off-stage for you
Phase 2 · On the day
A short visit at the clinic
Phase 3 · After
Concierge, back on
- 01
Before
You tell us what is going on
A short, confidential form. Pain pattern, MRI report if you have one, medications, and what has already been tried.
- 02
Before
We come back with a recommendation
Within one working day: the right injection type, the right level, the right steroid, an indicative price. If injection is not the right step, we say so.
- 03
Before
We arrange the appointment
Usually within one to two weeks. Any anticoagulant or diabetic medication is reviewed with the team and you are told exactly how to prepare.
- 04
On the day
Arrival at the clinic
Arrival, consent and a chat with the pain consultant and radiographer. Local anaesthetic, with light IV sedation if you would prefer.
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On the day
The injection itself
15 to 30 minutes on the fluoroscopy or CT table, prone, with contrast confirming needle position before the steroid is delivered.
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On the day
Home the same day
A short recovery, written aftercare, and home within an hour or two. You walk out; with sedation you will need someone to collect you.
- 07
After
Effect and review
Numbness settles by evening. Pain relief typically builds over 3 to 7 days and lasts 4 to 12 weeks. A review is arranged to plan next steps.
Typical end-to-end: 1–2 weeks from enquiry to injection. Effect: 4–12 weeks.
When it helps
When an epidural steroid injection is the right step.
The situations we see most, plus the one red flag that means an emergency rather than an appointment.
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Acute severe sciatica
MRI-confirmed nerve root compromise with radicular leg pain when medication and physiotherapy have not been enough.
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Cervical radiculopathy
Nerve root pain radiating into the arm from a disc prolapse or foraminal narrowing — cervical transforaminal or interlaminar options.
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Lumbar disc prolapse with leg pain
A prolapsed disc pressing on a nerve root, causing pain down the leg in a nerve distribution.
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Foraminal or lateral recess stenosis
Bony or ligamentous narrowing squeezing a single nerve root — often responds well to a targeted transforaminal injection.
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Post-surgical radicular pain
Ongoing nerve root pain after previous back surgery — a caudal approach is often preferred where scar tissue makes interlaminar access harder.
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Bridge to surgery, or instead of it
A window of relief to complete rehabilitation, or a way to avoid surgery altogether. Some studies show reduced surgical rates at 12 months.
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Chronic pain management
Where nerve root pain is part of a longer-term pain problem, repeat injections up to 3 to 4 per year sit alongside physio, medication and pain psychology.
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Red flag: cauda equina
Saddle numbness, new bladder or bowel disturbance, or bilateral leg weakness are an emergency — same-day A&E, not a clinic booking.
Injection options
Not every epidural is the same.
What each approach actually involves — and which one fits which pattern of pain.
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Interlaminar ESI (lumbar)
The traditional midline lumbar approach, between the vertebral laminae. Delivers steroid to the epidural space over one or two levels.
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Transforaminal ESI
A targeted approach through the intervertebral foramen to a single nerve root — the option of choice when one nerve is clearly the culprit on MRI.
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Caudal ESI
Via the sacral hiatus into the caudal epidural space. Useful for multi-level pain, previous back surgery, or when interlaminar access is difficult.
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Cervical transforaminal
For nerve root pain in the arm. Non-particulate dexamethasone is used to reduce the small but catastrophic risk of vertebral artery embolic events.
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Cervical interlaminar
A midline cervical approach where transforaminal is not indicated. Careful fluoroscopy and loss-of-resistance technique by a consultant only.
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CT-guided ESI
Preferred where the anatomy is complex, previous surgery has changed the landmarks, or an extremely precise transforaminal approach is planned.
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ESI under light sedation
Local anaesthetic plus a small dose of IV sedation for anxious patients. You are drowsy but breathing on your own and can respond.
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Consultation only
An honest discussion of whether injection is worth doing at all — MRI review, pain pattern and expected effect — with no obligation.
Our vetted London network
A small panel of pain consultants, we picked them.
Consultant pain specialists across central, north, west and south London. Not listed publicly — introductions are made privately, once we understand your case.
Selection criteria
How we choose every pain consultant in our network.
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Consultant pain specialists on the Faculty of Pain Medicine specialist register
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Fluoroscopy or CT guidance for every injection — no landmark-only technique
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Non-particulate dexamethasone used for all cervical transforaminal work
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Anticoagulation and diabetes protocols agreed with the anaesthetic team before booking
Safety and recovery
What to expect afterwards — honestly.
An image-guided epidural steroid injection is a common day-case procedure. The things worth planning are your anticoagulation, your diabetes, and knowing what is normal after.
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Image guidance is standard
UK Faculty of Pain Medicine standards expect fluoroscopy or CT for epidural injections. Blind landmark technique is discouraged for good reason.
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Injection-site soreness and a steroid flare
A day or two of soreness at the needle site is common. A small number of people get a transient worsening of pain — the steroid flare — before improvement.
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Transient hyperglycaemia in diabetes
The steroid can push blood sugars up for a few days. If you have diabetes we coordinate monitoring and, if needed, insulin adjustment beforehand.
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Anticoagulation needs planning
Warfarin, apixaban, rivaroxaban, clopidogrel and similar drugs are reviewed by the team. Never stop them without advice — epidural haematoma is rare but serious.
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Dural puncture and headache
An accidental dural puncture is uncommon and usually settles with rest and fluids. Persistent postural headache is treated with a blood patch if needed.
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Infection is rare
Deep infection after a properly performed epidural injection is well under 0.1 per cent. Aseptic technique in theatre matters.
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Cervical particulate risk
Particulate steroid injected transforaminally in the neck carries a rare but catastrophic embolic stroke risk. Our network uses non-particulate dexamethasone as standard.
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How long the effect lasts
Relief typically builds over 3 to 7 days and lasts 4 to 12 weeks — sometimes longer. Effect is modest on average and variable between people.
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Red flags after the injection
New leg weakness, saddle numbness, bladder or bowel disturbance, spreading redness, or a severe postural headache are reasons to call the clinic or A&E the same day.
Reading your procedure note
Your procedure note in four parts. Read the last one first.
Whichever approach was used, the note the pain consultant sends you keeps to the same shape.
A quiet reminder
Procedural language is precise and can read coldly — we translate it for you.
If you would like us to talk you through the note before your review, just ask.
- 01 Header
Indication and level treated
Why the injection was done — sciatica, cervical radiculopathy, post-surgical pain — and which level and side were targeted.
- 02 Technique
Approach, guidance and drugs used
Whether it was interlaminar, transforaminal or caudal, whether fluoroscopy or CT was used, and the local anaesthetic and steroid delivered.
- 03 Findings
Contrast spread and any complications
Notes on where the contrast spread on imaging, whether the target nerve root was reached, and any intra-procedure issues.
- 04 Impression
Aftercare, expected effect, next steps
Read this first: what to expect over the next week, when to expect relief, and whether a repeat or a different treatment is planned.
Recognised by major UK insurers
Cover for epidural steroid injections varies by insurer and by indication — usually funded for MRI-confirmed radicular pain, sometimes limited to a set number per year. We confirm cover before booking.
Frequently asked
Everything we get asked about epidural steroid injections.
Quick answers on evidence, cost, how long it lasts, and what the real risks are.
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What is an epidural steroid injection for?
It is used mainly for nerve root pain — sciatica from a lumbar disc, or arm pain from a cervical nerve root — where medication and physiotherapy have not been enough. NICE NG59 supports its use in acute severe sciatica with MRI-confirmed nerve root compromise, before considering surgery.
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Does an epidural steroid injection work for ordinary back pain?
On its own, no. NICE NG59 does not recommend epidural steroid injections for axial or mechanical low back pain without a radicular component. The evidence supports it for nerve root pain, not for back pain alone.
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How long does the pain relief last?
Relief typically starts over 3 to 7 days and lasts 4 to 12 weeks, occasionally longer. The effect is modest on average — some people get very good relief, some very little. In some studies it reduces the rate of surgery at 12 months.
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How much does a private epidural steroid injection cost in London?
Roughly £900–£1,600 for a lumbar interlaminar injection under fluoroscopy, £1,100–£1,900 for a lumbar transforaminal, £850–£1,500 for a caudal, and £1,400–£2,400 for a cervical transforaminal. Light IV sedation adds £400–£800. We confirm a firm figure within one working day.
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How many can I have in a year?
Up to three or four in a 12-month period is the usual UK ceiling. Any more than that and we would want to rethink the strategy rather than keep repeating the same injection.
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Is it done under general anaesthetic?
No — almost never. It is done awake under local anaesthetic, with light IV sedation if you would rather not be fully aware. Being awake lets the team check the needle position from your response.
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Can I drive home afterwards?
After a plain local-anaesthetic injection, most people can drive the next day. If you had sedation, you will need someone to collect you and you should not drive for 24 hours.
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What are the main risks?
Common: injection-site soreness, a short pain flare, transient blood sugar rise in diabetes. Uncommon: dural puncture with headache, transient low blood pressure. Rare: infection (well under 0.1 per cent), epidural haematoma. Very rare but catastrophic: embolic stroke or cord infarct with particulate steroid in the neck — mitigated by using non-particulate dexamethasone for cervical transforaminal work.
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