How does an epidural injection help relieve the pain from a back injury?

Not all back injuries will or can respond to epidural injections - injections directly into the spine.

If an epidural injection is the recommended treatment, it can help by injecting the medication directly to the area causing the pain. The medication could be an anti-inflammatory and/or an anesthetic to numb the pain.

Some types of injections are meant to damage the pain pathways, so the pain sensation can't be transmitted.

Reference:

Fred Rincon, MD, et al. Chronic myelopathy due to a giant spinal arachnoid cyst: a complication of the intrathecal injection of phenol. In Journal of Neurosurgery: Spine. April 2008. Vol. 8. Pp. 390-393.'

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