By the Pain Management Team at Performance Pain and Sports Medicine
Matthias Wiederholz, MD
Updated April 2026
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Back, neck, or radiating nerve pain has a particular way of taking over a day. The drive on Route 1 to a desk at Bristol Myers Squibb or ETS becomes its own ordeal; the walk to a Lawrenceville School classroom or up the stairs at home turns into a calculation. When physical therapy and oral medications have not produced enough relief, an epidural steroid injection (ESI) is often the next reasonable step before considering surgery.
At the Lawrenceville office of Performance Pain and Sports Medicine, located on Quakerbridge Road just off U.S. Route 1, Dr. Matthias Wiederholz performs epidural steroid injections under fluoroscopic guidance to deliver targeted anti-inflammatory medication exactly where the inflamed nerve root sits. As a quadruple board-certified pain medicine and sports medicine physician, Dr. Wiederholz reviews each patient’s MRI and symptom pattern to determine whether an ESI is the right tool for their specific source of pain rather than a generic treatment plan.
The Lawrenceville office serves the Princeton corridor, the Trenton-Princeton metro, and the wider Mercer County area. If chronic spine pain has limited your work, family time, or weekend on the Lawrence Hopewell Trail, an evaluation with the Lawrenceville team is encouraged.
What Is an Epidural Steroid Injection?
An epidural steroid injection (ESI) delivers anti-inflammatory medication directly into the epidural space surrounding your spinal nerves. The epidural space is the area between the protective covering of the spinal cord (the dura) and the vertebrae. When a herniated disc, bone spur, or narrowed spinal canal presses on a nerve root, it creates inflammation that drives pain, numbness, or weakness into your back, neck, arms, or legs.
The injection contains two components: a corticosteroid that reduces inflammation at the nerve root and a local anesthetic that provides immediate but temporary pain relief. Together, these medications calm the irritated nerve and create a window for healing and rehabilitation.
All epidural steroid injections at Performance Pain and Sports Medicine are performed under fluoroscopic guidance, which means real-time X-ray imaging is used to guide the needle to the precise location. This image-guided approach helps ensure the medication reaches the targeted nerve root accurately. According to the American Society of Interventional Pain Physicians (ASIPP), fluoroscopically guided epidural injections carry Level I evidence supporting their long-term effectiveness for conditions like disc herniation (Manchikanti L et al., Pain Physician, 2021).
Three primary approaches to ESI are used, selected based on your specific condition and anatomy:
- Interlaminar: The needle enters between two vertebrae from the back. This is the most common approach and covers a broad area of the epidural space.
- Transforaminal: The needle enters from the side, targeting the specific nerve root where it exits the spine. This delivers a more concentrated dose to the affected nerve.
- Caudal: The needle enters through the sacral opening at the base of the spine. This approach is often used for lower back conditions affecting multiple nerve levels.
The most appropriate approach is recommended after reviewing your imaging and evaluating your symptoms during the consultation.
Conditions Treated with ESI in Lawrenceville
Lawrenceville’s working population skews toward knowledge workers, faculty, healthcare professionals, and active retirees, and that shapes the spine conditions we see day to day. Long hours at a Bristol Myers Squibb bench or an ETS workstation, repetitive forward-head posture during microscopy or grading, and decades of commuting on Route 1 and the Northeast Corridor all contribute to the disc and nerve-root problems that ESIs treat. A 2022 systematic review in Pain Physician confirmed that epidural injections are effective for lumbar radiculopathy (Manchikanti L et al., 2022), and the American Academy of Neurology (2025) found that ESIs probably reduce short-term pain and disability in both cervical and lumbar radiculopathies (Armon C et al., Neurology, 2025).
Conditions commonly treated with epidural steroid injections at the Lawrenceville office include:
- Herniated or bulging disc. A frequent finding in pharma scientists, ETS researchers, and prep-school faculty whose long workdays load the lumbar spine. Targeted injection at the inflamed nerve root often allows patients to participate fully in physical therapy and return to work.
- Sciatica (lumbar radiculopathy). Shooting pain that runs from the lower back through the buttock and down the leg. We see it in commuters from Hopewell, Pennington, and Hamilton whose drives chain hours of seated, vibration-loaded posture together.
- Spinal stenosis. Narrowing of the spinal canal that compresses nerves and produces leg cramping with walking. ESI can extend mobility for older patients across central New Jersey who want to keep walking the Lawrence Hopewell Trail and the Delaware & Raritan Canal.
- Cervical radiculopathy. Nerve compression in the neck that radiates into the shoulder and arm, common in laboratory bench scientists, dental and surgical providers, and microscopy users in the Princeton-Trenton corridor.
- Degenerative disc disease. The natural loss of disc height and hydration over decades that irritates surrounding nerves. ESI can quiet the local inflammation while patients work with physical therapy on stabilization.
- Failed back surgery syndrome. Persistent nerve irritation after a prior spinal procedure. Many of our Lawrenceville patients arrive after surgery elsewhere with continued symptoms, and a targeted ESI is often part of the next plan.
- Spondylolisthesis. When a vertebra slips forward over the one below it and produces nerve compression that may respond to epidural steroid treatment.
During the Lawrenceville consultation, your MRI or other imaging is reviewed to identify which condition is driving your symptoms and whether an ESI is the right next step.
What to Expect During Your ESI in Lawrenceville
Knowing exactly what happens before, during, and after the procedure helps Lawrenceville patients arrive prepared and leave with a clear plan. Here is the step-by-step process at the Quakerbridge Road office.
Before Your Procedure
Your epidural steroid injection begins with a thorough evaluation in the Lawrenceville office. Dr. Wiederholz reviews your MRI or CT imaging, your pain history, prior physical therapy notes, and any earlier injections, then confirms that an ESI is appropriate for your specific condition. You will receive written instructions about which medications to pause beforehand, particularly blood thinners. Plan to have someone available to drive you home; this is car-dependent territory and we recommend not driving immediately after the procedure.
During Your Procedure
The injection itself typically takes 15 to 30 minutes and is performed as an outpatient procedure. You lie face down on a procedure table; the injection area is cleansed and numbed with a local anesthetic. Using fluoroscopic real-time X-ray guidance, Dr. Wiederholz advances the needle precisely into the epidural space at the targeted level of your spine. Once correct needle placement is confirmed on the fluoroscopy monitor, the corticosteroid and anesthetic medication are delivered. Most patients describe the sensation as pressure rather than sharp pain.
After Your Procedure
You rest in the recovery area for 15 to 30 minutes while the care team monitors you. Some patients notice immediate relief from the local anesthetic, although that effect is temporary. The corticosteroid typically takes two to seven days to reach its full anti-inflammatory effect. Most patients return to light daily activities the following day; strenuous exercise and heavy lifting are best avoided for 24 to 48 hours. Because central New Jersey winters bring ice and snow, your team will discuss home setup and entryway safety if you are scheduling during winter months. A follow-up visit at the Lawrenceville office is scheduled to assess your response and determine whether additional injections may be beneficial.
Benefits of Epidural Steroid Injections
For Lawrenceville-area patients dealing with chronic back or neck pain from nerve compression, epidural steroid injections offer several meaningful advantages as part of a comprehensive treatment plan:
- Minimally invasive and non-surgical. An ESI requires only a needle insertion. There are no incisions, no general anesthesia, and no hospital stay. You go home the same day.
- Targeted inflammation reduction. Unlike oral medications that circulate through the entire body, an epidural injection delivers the anti-inflammatory medication directly to the inflamed nerve root, which matters for patients in safety-sensitive or evidence-conscious professions across the Princeton corridor.
- May reduce or delay the need for surgery. Research published in The Spine Journal followed patients for five years after lumbar transforaminal ESI and found sustained benefit with reduced progression to surgical intervention (Kennedy DJ et al., 2018).
- Enables full participation in rehabilitation. One of the most important benefits is that ESI pain relief lets you engage fully in physical therapy and exercise, which are essential for long-term recovery and return-to-work timing.
- Quick procedure with fast recovery. The injection takes 15 to 30 minutes, and most Lawrenceville patients resume light activities the next day. There is no extended downtime.
- Can be repeated if effective. If the first ESI provides meaningful relief, your physician may recommend a series of up to three injections to extend the benefit. ASIPP guidelines support repeated epidural injections when clinical improvement is documented (Manchikanti L et al., Pain Physician, 2021).
ESIs work best as one component of a broader pain management strategy and are typically combined with physical therapy, activity modification, and other conservative treatments tailored to your specific condition and goals.
If you are considering an epidural steroid injection for back or neck pain, call the Lawrenceville office at 609-588-8600 to schedule a consultation.
Why Choose Performance Pain in Lawrenceville for Epidural Steroid Injections
Choosing the right physician for an epidural steroid injection matters. ESI outcomes depend on accurate diagnosis from your imaging, precise needle placement under live fluoroscopy, and disciplined patient selection. These require a physician with deep training in interventional spine procedures and a team that knows the patients of central New Jersey, the rhythms of the Princeton corridor, and the realities of commuting on Route 1 and the Northeast Corridor.
At Performance Pain and Sports Medicine in Lawrenceville, ESIs are performed by:
- Dr. Matthias Wiederholz, MD — Founder of Performance Pain and Sports Medicine and quadruple board-certified in Physical Medicine & Rehabilitation, Sports Medicine, Pain Medicine, and Anti-Aging, Regenerative & Functional Medicine. Dr. Wiederholz brings decades of fluoroscopy-guided interventional experience and was the first physician to bring Discseel® to New Jersey. He sees patients from Princeton, Princeton Junction, Pennington, Hopewell, Hamilton, Ewing, Plainsboro, West Windsor, and Trenton at the Lawrenceville office.
What sets the Lawrenceville office apart:
- Physician-led care with one of New Jersey’s most experienced interventional pain physicians
- Every epidural injection performed under live fluoroscopic guidance for precision
- Dedicated one-on-one consultation time, not a five-minute hallway visit
- Imaging review and pattern-of-pain analysis before any procedure is recommended
- Convenient Lawrenceville location on Quakerbridge Road, accessible from Princeton, Trenton, Hopewell, Hamilton, Ewing, Pennington, Plainsboro, and West Windsor
- Workers’ compensation accepted for pharma, healthcare, and education-sector cases
For Lawrenceville patients exploring biologic alternatives or adjuncts to ESI, the practice also offers PRP therapy in Lawrenceville.
Our Lawrenceville Location
The Lawrenceville office of Performance Pain and Sports Medicine occupies Suite 112 at 4056 Quakerbridge Road, a short drive from the Bristol Myers Squibb Lawrenceville campus, Educational Testing Service, The Lawrenceville School, Rider University, and the historic Main Street village. Quakerbridge Road sits just off U.S. Route 1, the spine of the Princeton-to-New Brunswick research corridor, with quick access to I-95, I-295, and Princeton Junction station for patients arriving from New York City or Philadelphia.
Performance Pain and Sports Medicine — Lawrenceville
Address: 4056 Quakerbridge Road, Suite 112, Lawrenceville, NJ 08648
Major Cross Streets: Quakerbridge Road at Province Line Road, just off U.S. Route 1
Nearby Landmarks: Quaker Bridge Mall, Bristol Myers Squibb Lawrenceville campus, Educational Testing Service
Parking: Free on-site parking
Phone: 609-588-8600
Conveniently located between Princeton and Trenton along the U.S. Route 1 research corridor, the Lawrenceville office serves patients from Princeton, Pennington, Hopewell, Hamilton, Ewing, Plainsboro, West Windsor, Robbinsville, and the wider Mercer County and Bucks County communities.
Frequently Asked Questions: ESI in Lawrenceville
Are epidural steroid injections available in Lawrenceville, NJ?
Yes. Epidural steroid injections are performed at the Lawrenceville office of Performance Pain and Sports Medicine, located at 4056 Quakerbridge Road, Suite 112. Dr. Matthias Wiederholz, MD, performs ESI under live fluoroscopic guidance for patients across the Princeton corridor and the wider Trenton-Princeton metro. Most insurance plans, Medicare, and workers’ compensation cases cover medically necessary ESI. Call 609-588-8600 or request an appointment online.
Do you accept workers' compensation for pharma, healthcare, and prep-school staff back injuries?
Yes. The Lawrenceville office regularly treats workers’ compensation patients from Bristol Myers Squibb, Educational Testing Service, Penn Medicine Princeton, Capital Health, RWJBarnabas, The Lawrenceville School, Rider University, and other major Mercer County employers. We coordinate with case managers and adjusters and document objective findings that support appropriate work status decisions. Call 609-588-8600 to discuss your specific case.
Do you accept referrals from Princeton-area primary care, neurosurgeons, and orthopedists?
Yes. Dr. Wiederholz routinely accepts referrals from Penn Medicine Princeton Medical Center, Capital Health, RWJBarnabas / RWJUH Hamilton, St. Francis Medical Center, and independent primary care, neurology, neurosurgery, orthopedic, and physical therapy practices across Mercer, Bucks, and Hunterdon counties. Most patients are seen within one to two weeks. Records can be sent through your referring practice or directly to the Lawrenceville office at 609-588-8600.
Will an epidural steroid injection help a herniated disc?
Herniated discs are one of the most common conditions we treat with ESI in Lawrenceville. Research supports the use of epidural injections for reducing pain and inflammation caused by disc herniation, particularly when the disc is compressing a spinal nerve. However, not every herniated disc requires an injection; some respond well to physical therapy alone. Your imaging and exam findings guide that recommendation.
How long does pain relief last after an epidural steroid injection?
Duration of relief varies. Some Lawrenceville patients experience weeks of relief, while others benefit for several months or longer. A 2025 systematic review published in Neurology found that epidural steroid injections probably reduce short-term pain in cervical and lumbar radiculopathy (Armon C et al., Neurology, 2025). ESIs work best when paired with active rehabilitation.
How many epidural steroid injections can I receive?
There is no single universal limit, but most physicians follow a guideline of no more than three to four ESIs within a six-month period. The decision depends on your response to the first injection and whether the clinical benefit justifies additional treatments. ASIPP guidelines support repeated injections when documented clinical improvement is present.
Does insurance cover epidural steroid injections?
Most insurance plans cover ESI when it is medically necessary and supported by imaging and physical examination. Coverage details vary by plan and may require prior authorization. Call the Lawrenceville office at 609-588-8600 to verify your benefits before scheduling.
How soon can I return to work after an ESI in Lawrenceville?
Most patients return to light daily activities the next day, including desk-based work at BMS, ETS, or other Princeton-corridor employers. Strenuous exercise, heavy lifting, and prolonged bending are best avoided for 24 to 48 hours. The injection site may feel sore for a day or two; your physician will provide written aftercare guidance based on the type of injection performed.
Schedule Your Lawrenceville ESI Consultation
If chronic back pain, neck pain, or radiating nerve pain has limited your ability to work or stay active, an epidural steroid injection may help you find meaningful relief without surgery. Patients across central New Jersey are welcome to schedule a consultation with Dr. Wiederholz at the Lawrenceville office.
Performance Pain and Sports Medicine — Lawrenceville
4056 Quakerbridge Road, Suite 112, Lawrenceville, NJ 08648
Phone: 609-588-8600
MEDICAL DISCLAIMER
This article is for educational purposes only and does not replace professional medical advice, diagnosis, or treatment. The information presented reflects an interventional pain management perspective and is intended to support, not substitute, your relationship with a qualified healthcare provider. Individual results vary based on diagnosis, pain duration, overall health, and response to treatment. Some procedures may not be covered by insurance. Treatment outcomes depend on proper patient selection and accurate diagnosis. Always consult a board-certified physician before pursuing any pain management treatment.
Performance Pain and Sports Medicine
Medically reviewed by Matthias Wiederholz, MD — Quadruple Board-Certified in Physical Medicine & Rehabilitation, Sports Medicine, Pain Medicine, and Anti-Aging, Regenerative & Functional Medicine. Last reviewed April 2026.
