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Interventional pain · UK

Spinal injections - image-guided, at the right level.

Epidural, nerve root, facet and sacroiliac injections placed by a consultant under live fluoroscopy or CT.

See indicative pricing
A radiographer guides a patient onto the bed of an advanced 3 Tesla MRI scanner in a London imaging suite

Indicative pricing

What a private spinal injection costs in the UK.

Indicative ranges across our partner pain and radiology units.

In short

£1,100–£1,900, home the same day.

Procedure Indicative range
Caudal epidural steroid injection £900–£1,600
Lumbar transforaminal nerve root block £1,100–£1,900
Lumbar facet joint injection (per level) £950–£1,700
Medial branch block, lumbar (diagnostic) £1,000–£1,800
Sacroiliac joint injection £950–£1,700
Cervical transforaminal or interlaminar epidural £1,400–£2,400
Radiofrequency denervation (per level, bilateral) £2,200–£4,500
Pain consultation with MRI review £280–£480

Prices vary by hospital, by the consultant, by image guidance (fluoroscopy or CT), and by whether more than one level is treated at the same sitting. Cervical work and radiofrequency sit at the top of the range.

The problem

The right target, the right level, and the right operator.

Spinal injections fail most often when the imaging is not reviewed, the wrong level is chosen, or the injection is done without live image guidance.

  • MRI first, needle second

    The imaging is the map. If your pain does not match the level being offered, we say so and change the plan.

  • Live image guidance, every time

    Fluoroscopy or CT with contrast confirmation - never blind, never in a treatment room.

  • A diary that decides the next step

    A structured two-week diary tells us whether it worked and what to do next. No diary is why patients end up on their fourth failed injection.

The journey

From MRI review to the diary - what happens, in order.

One team from first message through the injection, the diary and the physiotherapy build-back.

  1. 01

    Before

    A short form: where the pain goes, what makes it worse, imaging so far, medications tried. Upload the MRI report or the images themselves.

  2. 02

    Before

  3. 03

    Before

    Consent, blood thinners and fasting

    Stop anticoagulants where safe and agreed with your prescriber. Light meal on the day is usually fine for local-anaesthetic-only injections; sedation lists fast from six hours.

  4. 04

    On the day

    Admission and imaging setup

    Same-day admission. Position prone on the fluoroscopy or CT table. Skin marked and cleaned. Local anaesthetic to the skin and deeper tissues.

  5. 05

    On the day

    The injection itself

    Needle placed under live image guidance. Contrast confirms the target. Steroid and local anaesthetic delivered. Total time in the room: 10–25 minutes for most single-level procedures.

  6. 06

    On the day

    Recovery and discharge

    One to two hours of observation. Numbness or heavy legs settle within a few hours. Home the same day with written aftercare and a pain diary.

  7. 07

    After

    Diary, review and next step

    Two-week pain diary. Phone or clinic review at 2–4 weeks. If it worked, we plan the physiotherapy build-back; if it did not, we reopen the diagnosis with your consultant.

Typical end-to-end: 1–2 weeks from first appointment to injection. Back to desk work: the next day.

When it helps

When a spinal injection is the right step.

The situations we see most, plus the one red flag that means A&E rather than an outpatient booking.

  • Sciatica from a disc prolapse

    Leg-dominant pain in a nerve distribution matched by MRI - a transforaminal root block can settle inflammation and buy time for the disc to resolve.

  • Neurogenic claudication

    Bilateral leg pain on walking from spinal stenosis - a caudal or interlaminar epidural often gives months of walking distance back.

  • Axial facet-pattern back pain

    Pain worse with extension and rotation, localised to the spine itself - a diagnostic medial branch block confirms it and opens the door to radiofrequency.

  • Sacroiliac joint dysfunction

    Buttock pain that points to the SI joint on examination - a guided intra-articular injection is both diagnostic and therapeutic.

  • Cervical radiculopathy

    Arm pain and tingling in a nerve distribution from a cervical disc or foraminal stenosis - a targeted cervical epidural can avoid or delay surgery.

  • Post-surgical residual radicular pain

    Ongoing leg pain after discectomy or decompression, with a matching residual finding on MRI - an image-guided root block often helps.

  • Bridging to definitive treatment

    Pain control while a two-week-wait scan, MDT decision or an operating date is being arranged.

  • Red flag: cauda equina symptoms

    New saddle numbness, urinary retention or bilateral leg weakness is a same-day A&E emergency, never an outpatient injection booking.

Procedure options

The right injection depends on the pain generator.

The main techniques - where the needle goes, why, and what it treats.

  • Caudal epidural

    The sacral hiatus route into the epidural space. Simple, safe, well tolerated. Good for lower lumbar and sacral nerve roots and diffuse stenosis.

  • Interlaminar epidural

    Midline entry between the laminae under fluoroscopy. Delivers steroid closer to the target level in the lumbar or cervical spine.

  • Transforaminal (selective) nerve root block

    The most targeted option. Needle into the foramen at the exact affected nerve, contrast confirmation, then steroid and local anaesthetic. Diagnostic and therapeutic.

  • Facet joint and medial branch blocks

    For axial back or neck pain of facet origin. Medial branch blocks confirm the diagnosis and set you up for radiofrequency denervation.

  • Sacroiliac joint injection

    Intra-articular steroid and local anaesthetic under fluoroscopy or CT. Confirms the SI joint as the pain generator and treats it in one sitting.

  • Radiofrequency denervation

    Once positive medial branch blocks confirm the level, the small nerves to the facet joints are treated with radiofrequency for six to eighteen months of relief.

  • Cervical injections

    Cervical transforaminal and interlaminar epidurals for arm pain from cervical radiculopathy. Reserved for a consultant with a high cervical volume.

  • Discography and provocation testing

    A diagnostic tool where imaging is inconclusive - the disc is pressurised under image guidance to reproduce the pain and confirm the level.

Safety and recovery

What to expect afterwards - honestly.

Image-guided spinal injections are a low-risk daycase procedure. The honest conversation is about how long relief lasts and what to do if it does not work.

  • Local anaesthetic, sometimes light sedation

    Most injections are done awake with local. Light sedation is offered for cervical work or high anxiety - you must fast and be collected.

  • Bleeding and infection

    Both are rare - under 1 percent. Anticoagulants are stopped where safe. Fever, spreading redness or worsening pain in the days after is an urgent call, not a wait-and-see.

  • Steroid side effects

    A steroid flush, insomnia and a few days of higher blood sugar in diabetics are common. Menstrual timing may shift for one cycle.

  • Dural puncture and headache

    A postural headache after a needle brush of the dura - under 1 percent. Usually settles with rest, fluids and simple analgesia; a blood patch is rarely needed.

  • Nerve injury

    Very rare with image guidance. Live fluoroscopy or CT, contrast confirmation and a specialist operator are what keep this uncommon.

  • Post-injection flare

    A day or two of worse pain before it settles is normal. If pain is severe, prolonged or with new neurology, ring the on-call team.

  • When it works - and when to stop

    A positive response is 50 percent or better relief lasting weeks. If the second injection at the same target does nothing, a third is not the answer.

  • Steroid dose over a year

    We keep total steroid dose across joints and spine sensible over any twelve-month window - usually no more than three or four significant injections a year.

  • Red flags after injection

    New leg weakness, saddle numbness, urinary retention, uncontrolled fever or spreading back redness need A&E the same day, not the clinic tomorrow.

Reading your procedure note

Your procedure note in four parts. Read the last one first.

Whichever injection was done - nerve root, facet, epidural or SI joint - the note the specialist sends you keeps to the same shape.

A UK consultant pain specialist reviewing a patient’s injection notes

A quiet reminder

Procedure language is precise and can read coldly - we translate it for you.

If you would like us to talk you through the note and the diary before your review, just ask.

  1. 01 Header

    Indication, level and structure

    Why the injection was done, which side, which level, and whether the target was nerve root, facet, epidural or SI joint.

  2. 02 Technique

    Guidance, contrast and drug

    How the needle was placed - fluoroscopy or CT, contrast pattern seen, drug mix and volume delivered.

  3. 03 Findings

    Response in clinic

    What happened immediately: local anaesthetic effect, provocation response, any complications during the procedure.

  4. 04 Impression

    Diagnosis, plan and next review

    Read this first: what the injection tells us about the diagnosis, the physiotherapy plan, and when we look at you again.

Recognised by major UK insurers

BupaAXA HealthVitalityAvivaWPACignaHealixBupaAXA HealthVitalityAvivaWPACignaHealixBupaAXA HealthVitalityAvivaWPACignaHealix

Image-guided spinal injections are usually covered by UK private medical insurance when clinically indicated, up to a per-year injection limit that varies by policy.

Frequently asked

Everything we get asked about spinal injections.

Quick answers on how long they last, how painful they are, and when injection is not the right route.

  • How long do spinal injections last?

    It varies. A well-targeted nerve root block for sciatica often gives weeks to months of relief while the disc settles. Facet joint steroid is usually 3–6 months. Radiofrequency denervation after positive medial branch blocks typically lasts 6–18 months. Some patients get long-term relief; others use injections as a bridge to physiotherapy or surgery.

  • Are spinal injections painful?

    Skin numbing takes the edge off. Most patients describe pressure and a brief spike as the needle passes deep muscle or reaches the nerve. It is over in minutes. Sedation is available for cervical injections and high anxiety.

  • Will an injection fix my slipped disc?

    No - it treats the inflammation around the nerve, not the disc itself. Many disc prolapses shrink over three to twelve months on their own; an injection buys time and function while that happens. If it does not settle or leg weakness develops, spine surgery is the right conversation.

  • How much does a private spinal injection cost in the UK?

    Roughly £900–£1,600 for caudal epidural, £1,100–£1,900 for a lumbar nerve root block, £950–£1,700 for facet or SI joint, £1,400–£2,400 for cervical, and £2,200–£4,500 for radiofrequency denervation. Prices include the consultant, the theatre and imaging.

  • Can I have this on the NHS?

    Yes, but waits vary widely by region - often three to nine months from GP referral for a lumbar epidural, and longer for cervical work or radiofrequency. Private routes are quicker and let you keep the same consultant across imaging, injection and follow-up.

  • How soon can I drive and return to work?

    Drive when the local anaesthetic has fully worn off and you can perform an emergency stop - usually the next day for lumbar work, occasionally the same evening. Desk work the next day is realistic; heavy manual work and gym training after 48–72 hours.

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