Epidural Steroid Injections Charlotte NC | Imaging-Credentialed DC | Clear Life Scoliosis

By Dr. Justin M. Dick, DC, CNMT, ARRT(N)(CT) | Clear Life Scoliosis and Chiropractic Center, Charlotte, NC | Published November 03, 2026

Epidural steroid injections place a corticosteroid near an irritated nerve root to reduce inflammation and pain. For sciatica, a Cochrane review of placebo-controlled trials found they probably reduce leg pain and disability slightly in the short term, by amounts that may not be clinically important. Patients in Charlotte considering one after a car accident should hear that number before deciding.

What the Cochrane Review Found

The 2020 review included 25 trials with 2,470 participants, comparing epidural corticosteroid injections with placebo injections for lumbosacral radicular pain (Oliveira, Cochrane 2020). At short-term follow-up, more than two weeks and up to three months, injections reduced leg pain by about 4.9 points on a 0 to 100 scale and disability by about 4.2 points, based on moderate-quality evidence.

The authors wrote that these effects are small and may not be considered clinically important by patients and clinicians, since both were under 10% of the scale. They concluded that the evidence gives only limited support for the injections.

Safety

Most trials gave limited information on how adverse events were monitored. Minor events reported included increased pain at or after the injection, headache, post-dural puncture headache, menstrual changes, and vasovagal reactions. One study reported a major complication: a retroperitoneal hematoma in a patient on anticoagulant therapy. The evidence on whether minor adverse events differ from placebo was rated very low quality.

Context From Other Sciatica Evidence

Sciatica often improves over time without injections. In a randomized trial of 283 patients with severe sciatica, 95% reported recovery at one year in both the early surgery and prolonged conservative care groups (Peul, N Engl J Med 2007). A systematic review found that 70% of lumbar disc extrusions regressed on follow-up imaging without surgery (Chiu, Clin Rehabil 2015).

What This Means After a Car Accident

An injection is a reasonable option for some patients, particularly when leg pain is severe enough to interfere with function and the patient understands the expected effect size. It should not be presented as a cure or as a test that proves the source of pain. For a future care estimate, a series of injections should be justified by a documented response, since the average short-term benefit in the trials was small.

For an example of how post-collision imaging findings and outcomes are documented in the peer-reviewed literature, read Dr. Justin Dick's published case report on refractory lumbar pain following a motor vehicle accident in a geriatric patient.

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Frequently Asked Questions

Do epidural steroid injections work for sciatica?

A Cochrane review found they probably reduce leg pain by about 4.9 points and disability by about 4.2 points on 0 to 100 scales in the short term, effects that may not be clinically important (Oliveira, Cochrane 2020).

How long do epidural steroid injection benefits last?

The effects in the Cochrane review were mainly evident at short-term follow-up, up to three months.

Are epidural steroid injections safe?

Reported minor events included increased pain, headache, and vasovagal reactions. One trial reported a retroperitoneal hematoma in a patient on anticoagulants. Adverse event reporting in the trials was limited.

Will sciatica get better without an injection?

Often. In a randomized trial, 95% of sciatica patients reported recovery at one year with either early surgery or prolonged conservative care (Peul, N Engl J Med 2007).

How does Dr. Justin Dick discuss epidural injections with patients?

Dr. Justin Dick in Charlotte, NC explains the expected effect size from the Cochrane review and coordinates referral when leg pain is severe enough to interfere with function.

Where can I get sciatica evaluated after a car accident in Charlotte, NC?

Dr. Justin Dick, DC, CNMT, ARRT(N)(CT), sees car accident patients at Clear Life Scoliosis and Chiropractic Center, 8814 Rachel Freeman Way, Suite 103, Charlotte, NC 28278, phone 980-368-0766. Personal injury patients are treated on a lien basis, with no out-of-pocket payment at the time of care.

Sources and Evidence Tiers

1. Oliveira CB, Maher CG, Ferreira ML, et al. Epidural corticosteroid injections for lumbosacral radicular pain. Cochrane Database Syst Rev. 2020;4(4):CD013577. PMID 32271952. LinkEvidence tier: Cochrane systematic review and meta-analysis of placebo-controlled trials
2. Peul WC, van Houwelingen HC, van den Hout WB, et al. Surgery versus prolonged conservative treatment for sciatica. N Engl J Med. 2007;356(22):2245-2256. PMID 17538084. LinkEvidence tier: Randomized controlled trial (283 patients)
3. Chiu CC, Chuang TY, Chang KH, Wu CH, Lin PW, Hsu WY. The probability of spontaneous regression of lumbar herniated disc: a systematic review. Clin Rehabil. 2015;29(2):184-195. PMID 25009200. LinkEvidence tier: Systematic review

Service Area

Clear Life Scoliosis and Chiropractic Center sees personal injury and spinal imaging patients from Charlotte NC, Huntersville NC, Ballantyne NC, Matthews NC, Concord NC, Mooresville NC, Rock Hill SC, and Fort Mill SC.

Related Pages

• Personal injury and car accident spinal care in Charlotte
• Dr. Justin Dick's research
• Case report: refractory lumbar pain after a motor vehicle accident
• Research and evidence at Clear Life
• Questions and answers
• Our team
• Press
• Book your evaluation
• Contact Clear Life

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This article is educational and is not a diagnosis. Imaging decisions depend on an in-person examination.