An epidural injection is usually administered with the patient comfortably lying face down. The back is cleansed with an antiseptic and x-ray images are made in real time to identify the structures of the spine to aid in guiding the injection. A numbing medicine is placed just under the skin to numb the area. Sometimes more than one site on the spine in treated so there may be several numbed areas on the skin. A very small wire-like needle is used to deliver the medication at the appropriate site.