Our Treatments

What is a Transforaminal Epidural Steroid Injection?

A transforaminal epidural is similar to an Epidural injection in that medication is injected into the epidural space to decrease inflammation and alleviate pain. The main difference is that an epidural steroid injection spreads the medication into the back of the epidural space and along a more diffuse pattern allowing the medication to spread to multiple levels during a single injection. A Transforaminal epidural steroid injection spreads the medication into the front of the epidural space and is more specific to certain levels and certain affected nerve roots.

How does this procedure work?

You will be provided with light IV sedation or a small sedative to help with anticipated anxiety, however sedation is not required. You will lie on an x-ray table; the target area will be prepped and the procedure will be conducted under sterile conditions while using fluoroscopy (x-ray) guidance.

Fluoroscopy allows the doctor to watch the needle in real-time on the monitor to ensure the medication is injected into the desired location. Some discomfort may occur, but patients more commonly report experiencing a feeling of pressure versus pain. Once the procedure is complete, a band aid will be applied and the patient will be able to walk out of the office and continue with daily activity. The injection itself only takes a few minutes, but the entire process may take between 15 and 30 minutes.

Medications injected include both a corticosteroid such as dexamethasone or methyl-prednisolone and an anesthetic numbing agent such as lidocaine or bupivacaine. The medications are delivered into the epidural space of the spine. Corticosteroid injections can reduce inflammation by flushing away proteins that cause swelling in the spine- this allows your spinal condition to improve with physical therapy and an exercise program while providing pain relief.

What are the benefits of this treatment?

The goal of this procedure is to reduce pain and inflammation so that you may resume normal activities and a physical therapy program. Duration of pain relief varies, lasting for weeks or years, and is dependent on each individual.

How many treatments will i need?

Pain relief can last days to years, and is dependent on each individual person. This injection may be repeated every 3 months. Injections are performed in conjunction with a physical therapy and/or home exercise program to strengthen the back muscles and prevent future pain episodes.

What is the recovery time of this procedure?

Once the procedure is complete, a band aid will be applied and the patient will be escorted to a recovery room where they will be monitored for a short time, and will be able to leave the office shortly after. Rarely temporary leg weakness or numbness can occur; therefore, you should have a driver attend the appointment with you to drive you home.

You will be able to walk immediately after the procedure and may feel slight discomfort, so it is recommended to take it easy for 24 hours and may resume full activity the next day. Soreness around the injection site is normal and may be relieved by using ice and taking a mild analgesic (Tylenol). It is a good idea to keep a record of your pain level during the next few weeks. You may notice a slight increase in pain, numbness or weakness as the numbing medicine wears off and before the corticosteroid starts to take effect.

What are the risks of this procedure?

Epidural steroid injections are considered an appropriate nonsurgical treatment for most patients. Potential risks associated with inserting a needle into the epidural space include spinal headache, bleeding, injection, allergic reaction, and nerve damage/paralysis (rare).

Corticosteroid side effects may include weight gain, water retention, hot flashes, mood swings, insomnia, and elevated blood sugar levels in diabetic individuals. Side effects are temporary and any numbness or mild muscle weakness usually resolves within 8 hours.