- What is a transforaminal epidural steroid injection?
A transforaminal epidural steroid injection is the injection of steroid into the opening at the side of the spine where the nerve root exits. This opening is known as the foramen. There is a small sleeve of the epidural space that extends out over the nerve root for a short
distance. The epidural root sleeve is just outside the spinal canal. These injections may also be known as selective nerve root injections.
- How do these injections help?
The steroid that is injected reduces the inflammation and swelling of the nerve root and other tissues. When inflammation and swelling are decreased, the pain should also decrease.
- How are transforaminal epidural steroid injections performed?
You will be placed on your abdomen on the X-ray table. The physician will clean your skin with an antibacterial solution. The physician will numb your skin. Using X-ray guidance, the physician will place a needle into the nerve foramen. The physician may inject contrast dye to ensure that medication is flowing along the nerve root. After the physician is satisfied with the needle placement, he will inject the medication and remove the needle.
- What medications are injected? The physician may inject contrast dye to ensure that medication is flowing along the nerve root. He will then inject a combination of local anesthetic, steroid and saline.
- How soon will the treatment help?
You may experience pain relief in 15-20 minutes due to the effect of the local anesthetic. Your pain may return in 4-6 hours as the local anesthetic wears off. The steroid typically takes 48-72 hours to be effective.
- Are transforaminal epidural steroid injections painful?
A local anesthetic is injected into the skin and deeper tissues to minimize discomfort. You may experience pressure as the medication is injected.
- How often may transforaminal epidural steroid injections be repeated?
The injection(s) may be repeated as soon as two weeks. You may have a total of three injections in six months or a total of four injections in a 12 month period.
- Are there risks or hazards?
As with any procedure, there is the potential for problems. The risks are very minimal with transforaminal epidural steroid injections. The problems that could occur are:
- Bleeding at the injection site
- Infection
- Temporary numbness or weakness in the leg on the side that was injected.
- Temporary loss of bladder control
- How should I care for myself after the injection?
You should take it easy on the day of the injection. Normally you can resume all of your normal activities on the following day.
In addition to resting on the day of the injection, you may apply ice to the injection site. If you choose to use ice, apply it 20 minutes on/20 minutes off. Heat may be applied after 24 hours. Again, do not leave heat on the area for more than 20 minutes at a time.
You should take your medications as usual and follow your prescribed diet.