Concierge pain medicine · UK
Sacral nerve root injection - precise, diagnostic, image-guided.
A targeted injection of local anaesthetic and steroid to a specific sacral nerve root under X-ray or CT guidance. Diagnostic first - to confirm the pain generator - and therapeutic second, to settle the inflammation for weeks or months.
Why patients choose us
- 01
A pain-medicine consultant, image-guided
You are matched to a consultant in pain medicine or musculoskeletal radiology, using X-ray fluoroscopy or CT - never a blind injection.
- 02
Diagnostic first, therapeutic second
A sacral nerve root injection is as much a test as a treatment. We use it to confirm the pain generator before any surgery is considered.
- 03
Independent, and free
We take no fee from clinics. If your pain is really from a facet joint or the SI joint, we say so - and target that instead.
Indicative pricing
What a private sacral nerve root injection costs.
Whole-visit ranges - the imaging suite fee, the consultant fee and the injectate are all in.
In short
Fluoroscopy-guided single-level: £850–£1,400, home the same day.
| Service | Indicative range | Typical duration | Turnaround |
|---|---|---|---|
| Single-level fluoroscopy-guided sacral nerve root injection | £850–£1,400 | 20–30 min | Same day |
| Two-level sacral nerve root injection | £1,100–£1,700 | 30–45 min | Same day |
| CT-guided sacral nerve root injection | £1,400–£2,000 | 30–45 min | Same day |
| Bilateral sacral nerve root injections | £1,500–£2,200 | 40–60 min | Same day |
| Pain-medicine consultation with imaging review | £300–£500 | 30–45 min | Same visit |
| MRI lumbar spine (if not already done) | £450–£700 | 30 min | 48 hours |
Prices depend on hospital, consultant and modality. CT-guided procedures cost more because of the extra imaging time.
The problem
Precision beats guesswork.
A blind steroid injection into the general area cannot answer the diagnostic question - and often misses the target. Image guidance changes both.
Confirm the pain generator
A precise root block that gives brief but definite relief tells the surgeon exactly which level to treat.
Reduce inflammation, not just numb pain
Steroid depots calm root irritation for weeks - not a rescue dose, a treatment.
A clean off-ramp
If two blocks give diminishing return, we escalate to RF, decompression or neuromodulation - with data to back the decision.
The journey
From enquiry to injection - what happens, in order.
One team from first message through imaging, injection and review.
Phase 1 · Before
Imaging, consent, checks
Phase 2 · On the day
Injection, recovery
Phase 3 · After
Diary, review, next step
- 01
Before
You send the details
Symptom pattern, dermatomal distribution, MRI or CT report if done, previous injections, and current medications including anticoagulants.
- 02
Before
We come back with a plan
Within one working day: which level (typically S1, S2 or S3), fluoroscopy or CT guidance, injectate, and a firm price.
- 03
Before
Pre-procedure checks
Anticoagulant plan agreed. Consent covers a temporary flare of leg pain, transient weakness and rare complications.
- 04
On the day
Positioning and imaging
Prone on the fluoroscopy or CT table. Skin marked over the target sacral foramen, local anaesthetic to the skin.
- 05
On the day
The injection itself
A fine (22-gauge) needle placed through the sacral foramen under live imaging. Contrast confirms epidural spread around the nerve root; steroid and local anaesthetic delivered.
- 06
On the day
Recovery and discharge
Twenty minutes on the recovery couch, a check of leg power and sensation, then home. No driving that day.
- 07
After
Pain diary and follow-up
Two-week pain diary to grade diagnostic value and duration. Telephone or clinic review at three to four weeks.
Enquiry to injection: 1 week. Peak steroid effect: 3–14 days.
When it helps
When a sacral root injection is the right tool.
The seven common scenarios plus the red flag that overrides everything.
Radicular leg pain (sciatica)
Dermatomal leg pain from S1 nerve root irritation - often from a lumbosacral disc prolapse or a foraminal osteophyte.
Perineal or genital nerve-root pain
S2–S4 root involvement can cause burning perineal, vaginal or scrotal pain - a targeted injection helps localise the level.
Persistent post-laminectomy syndrome
Radicular pain that persists after previous spine surgery - a nerve root block can clarify whether recurrent disc, scar tissue or another level is responsible.
Foraminal stenosis
Narrowing at the sacral foramen - the injection is both diagnostic and can settle inflammation.
Pre-surgical planning
When the MRI shows two possible pain sources, a selective root injection tells the surgeon which level to target.
Cancer-related sacral root pain
Metastatic disease or radiation-induced neuritis - targeted steroid and local anaesthetic can give useful relief while oncology plans.
Tarlov cyst-associated pain
Symptomatic perineurial cysts on a sacral root - targeted injection is sometimes tried before surgical options are considered.
Red flag: cauda equina syndrome
Saddle numbness, bladder or bowel dysfunction, bilateral leg weakness - this is not for an injection clinic. Same-day A&E with imaging.
Options
The full ladder of interventions.
Every option from single-shot injection to neuromodulation and surgery.
Fluoroscopy-guided (X-ray)
The standard technique - low radiation, real-time contrast confirmation, quick. Good for S1 in most patients.
CT-guided
Preferred for S2–S4 targets, unusual anatomy, prior fusion or when precise millimetre placement matters.
Steroid + local anaesthetic
The commonest injectate - bupivacaine and dexamethasone or triamcinolone. Local gives immediate relief; steroid gives weeks of anti-inflammatory effect.
Local anaesthetic only (pure diagnostic)
Used when the goal is purely to confirm the pain generator - no steroid, shorter effect, cleaner diagnostic signal.
Pulsed radiofrequency neuromodulation
Non-destructive RF applied to the nerve root - a next-step for patients who get short-lived benefit from steroid injection.
Caudal epidural
A broader-territory epidural through the sacral hiatus. Less selective but useful when several roots are involved.
Sacral neuromodulation
For bladder, bowel or pelvic pain rather than radicular pain - see the neuromodulation and sacral neuromodulation pages.
Surgical decompression
When repeated injections lose their benefit and imaging shows a clear surgical target, microdiscectomy or foraminotomy is discussed.
Our vetted UK network
Interventional pain teams, we picked them.
Consultant pain-medicine and interventional radiology teams across London, Manchester and Birmingham.
Selection criteria
How we choose every injection clinic in our network.
Consultant pain-medicine or interventional radiology delivery - no non-consultant lists
Fluoroscopy or CT guidance in every case, with contrast confirmation of nerve root spread
Written outcome-tracking with a two-week pain diary and dermatomal map
Clear onward pathway to surgery, RF or neuromodulation if steroid benefit is short-lived
Safety and recovery
What to expect afterwards - honestly.
Root injections are safe when done under imaging. The things worth planning are anticoagulants and the pain flare.
Local anaesthetic effect
The injected local can weaken the leg temporarily. No driving on the day. Full leg strength usually returns within four hours.
Pain flare
A short flare of the original pain over 24–72 hours is common as the steroid depot settles.
Bleeding
Uncommon. Anticoagulants are stopped for the procedure per BSIR guidance. Restarted the same evening in most cases.
Infection
Rare with proper skin prep. Deep epidural infection is exceptional but is why we operate a clean, imaging-guided setup.
Dural puncture and headache
A postural headache occurs in under 1 percent. Bed rest, fluids and - rarely - an epidural blood patch settle it.
Steroid side effects
Facial flushing, brief blood-sugar rise in diabetes, and a small temporary rise in blood pressure. All expected and short-lived.
Repeat injections
Standard practice is no more than three targeted steroid injections in a rolling twelve months at the same root.
When it does not work
A negative diagnostic block is useful information - it points away from that root and towards facet, SI joint or another source.
Red flags after injection
New leg weakness beyond four hours, saddle numbness, bladder or bowel change, fever, or severe worsening pain: same-day team or A&E.
Reading your notes
Your procedure note in four parts. Read the last one first.
Injection notes are short - but the diagnostic interpretation is what matters for next steps.
A quiet reminder
Keep the two-week pain diary.
Grade the immediate and delayed response - it is the single most useful data point for the next decision.
- 01Header
Level, side and modality
Which root injected (for example right S1), fluoroscopy or CT, contrast used and dose.
- 02Technique
Placement and confirmation
Needle path, contrast pattern, whether epidural spread was seen, and steroid and local delivered.
- 03Findings
Diagnostic response
Post-injection pain score, leg power check, and any observed provocation of typical symptoms during needle placement.
- 04Impression
Interpretation and next step
Read this first: what the block tells you, expected duration of steroid effect, and the next step if benefit is short-lived.
Recognised by major UK insurers
Image-guided nerve root injections are usually covered when medically indicated. We check cover in writing before booking.
Frequently asked
Everything we get asked about sacral root injections.
Quick answers on diagnostic value, duration, cost and next steps.
What exactly is a sacral nerve root injection?
A small volume of local anaesthetic and (usually) steroid is placed under X-ray or CT guidance right beside a specific sacral nerve root as it leaves the sacral foramen. It has two jobs: to confirm that root is the pain generator by giving temporary relief, and to reduce inflammation around the root so pain settles for weeks or months.
Is it the same as an epidural?
No. An epidural spreads medication across several roots in the epidural space; a sacral nerve root injection places it precisely at one root. That precision is why we use it - it is more diagnostic and often more effective for single-root pain.
How much does it cost privately in the UK?
Roughly £850–£1,400 for a single-level fluoroscopy-guided injection, £1,100–£1,700 for two levels, £1,400–£2,000 for CT-guided and £1,500–£2,200 for bilateral. Consultation and MRI, if not already done, are separate.
How long does relief last?
Immediate relief from the local anaesthetic lasts a few hours, then pain often returns for 24–48 hours. Steroid benefit usually kicks in from day three and can last weeks to several months. Diagnostic value is preserved either way - even a short response can confirm the level.
Will I be awake?
Yes. It is done under local anaesthetic with light sedation only if requested. Being awake lets you tell us when the needle reproduces your typical pain - that itself is diagnostic.
How many injections can I have?
Up to three targeted steroid injections at the same root in a rolling twelve-month period is standard practice. If benefit is short-lived we look at pulsed radiofrequency or, where imaging supports it, surgery.
Related treatments
Looking for something else?
Nerve root block
Nerve root blocks at other spinal levels.
Learn moreEpidural steroid injection
Wider-territory epidural.
Learn moreFacet joint denervation
Radiofrequency for facet pain.
Learn moreDorsal root ganglion block
DRG-targeted injection.
Learn moreSacral nerve stimulation
For pelvic and bladder/bowel dysfunction.
Learn moreAll tests & procedures
Every test and procedure we arrange.
Learn more