Epidural steroid injections are commonly used for the management of lumbosacral radicular syndromes. The literature is replete with case reports and noncontrolled studies, but relatively few controlled studies exist. The well-designed studies that are available, however, do show a significantly positive pain reducing benefit from lumbar epidural steroid injections. This Contemporary Concepts review summarizes theoretic concepts, clinical applications, and data from the literature regarding the use of lumbar epidural steroid injections and provides current recommendations and suggestions for future research.