Transforaminal Injection

IS A TRANSFORAMINAL EPIDURAL STEROID INJECTION RIGHT FOR YOU?

Transforaminal Epidural Steroid Injections are typically recommended for individuals experiencing nerve-related pain, such as lower back pain, leg pain, or sciatica, resulting from conditions like herniated discs, spinal stenosis, or nerve root compression (radiculopathy or radiculitis). These injections are particularly considered when the pain is thought to originate from specific spinal nerves that are inflamed or irritated.

Candidates are usually those who have not found sufficient relief from conservative treatments, such as rest, physical therapy, or lifestyle changes. A thorough evaluation is necessary to confirm whether TFESI is a suitable option based on the patient’s medical history, symptoms, and underlying condition.

HOW DO TRANSFORAMINAL EPIDURAL STEROID INJECTIONS WORK?

The spinal cord travels from the brain to the waist in a tunnel in the back part of the spine. About every inch along the way, the spinal cord gives off branches (spinal nerves) to the right and left. These spinal nerves carry sensations and pain signals from the various parts of the body back to the brain. Corticosteroids are very potent anti-inflammatory medications that work best when they are injected into the area where the inflammation is occurring. A TFESI allows the medication (steroid) to come into direct contact with the inflamed spinal nerve(s), reducing the pain associated with the inflammation.

WILL TRANSFORAMINAL EPIDURAL STEROID INJECTIONS HELP MY PAIN?

The effectiveness of TFESI can vary depending on the underlying condition, the severity of the nerve inflammation, and individual factors such as daily activities and lifestyle. Many people experience significant pain relief after a single injection, while others may require additional injections or complementary treatments. The injection may help reduce pain enough to facilitate participation in physical therapy or other rehabilitation efforts.

HOW EFFECTIVE ARE TRANSFORAMINAL EPIDURAL STEROID INJECTIONS FOR PAIN RELIEF?

TFESI is generally effective in reducing nerve-related pain for many patients. The relief may range from immediate to gradual over several days. While some individuals experience prolonged benefits lasting several months, others may need repeated injections for sustained pain management. The procedure is considered most effective when integrated into a comprehensive pain management plan.

What to Expect During the Procedure

At your first visit, your doctor will talk with you about your symptoms, review any scans or test results, and go over the medicines you take.

On the day of the injection, you’ll lie on an X-ray table. The skin on your back will be cleaned and numbed with a small shot of local anesthetic. Then, using live X-ray guidance, your doctor will gently guide a thin needle to the irritated nerve. A small amount of contrast dye is used to make sure the medicine goes to the right place. The steroid medicine is then slowly injected into the space around the nerve. When the injection is done, the needle is removed and a small bandage is placed over the area.

What to Expect After the Procedure

Your blood pressure, pulse, and breathing will be checked frequently over the next 15 to 20 minutes. Once your vital signs are stable, you will be able to go home. Some people will experience immediate relief, however it usually takes 24 to 72 hours for the effects of the steroid medication to take effect and it may be up to 1 week before the maximum benefits are achieved. Very often more than 1 injection is necessary to achieve a good level of pain relief.

Follow-Up Care

You’ll return for a follow-up visit within one to two weeks after your injection. During this appointment, your doctor will review how much relief you experienced and how your daily activities have improved. If you felt meaningful relief, a second or series of injections may be scheduled to build on those results.

If your pain has not improved as expected, your provider may discuss other treatment options, such as different types of epidural injections, nerve blocks, or advanced therapies. Staying active and continuing any prescribed physical therapy can help maintain flexibility and support long-term pain control. Always let your care team know if your symptoms change or if you have any concerns between visits.

Common Questions About Transforaminal Epidural Steroid Injections

Does the injection hurt?

You may feel a quick pinch when the numbing medicine is applied, but most people describe the injection itself as a sense of pressure or mild discomfort rather than sharp pain.

How soon will I feel relief?

Some people notice improvement right away, but it often takes 24 to 72 hours for the steroid to begin working. The full benefit may take up to a week.

How long will the effects last?

Relief can last from several weeks to several months, depending on your condition and activity level. Your provider may recommend repeat injections or additional therapies if pain returns.

Can I drive myself home?

If you receive only local anesthesia, you can usually drive home. If light sedation is used, you’ll need someone to drive you and should rest for the remainder of the day.

Are there any restrictions after the procedure?

Take it easy for the rest of the day after your injection. You can return to normal activities the next day unless your doctor advises otherwise. Avoid strenuous exercise for 24 hours.