What is a transforaminal injection?
A Transforaminal Epidural Steroid Injection (TFESI) is an epidural steroid injection using the transforaminal approach. This is an advanced injection technique that directs the needle indirectly off-center instead of going through the center of the back or neck. The transforaminal technique delivers steroid medication precisely to the targeted painful structure and can help reduce the inflammation and alleviate the pain.
How is transforaminal injection done?
This is typically an outpatient procedure performed under sterile conditions. First, you may be given an intravenous medication to relax you, if this has been previously arranged. Then, you’ll lie on your stomach on an x-ray table. The doctor will numb an area of skin on your back with a local anesthetic. Then, guided by an x-ray, he or she will:
- Insert a thin needle into your back
- May inject dye to confirm that medication will go to the correct spot
- Inject a steroid (for longer term relief)
- Remove the needle and place a bandage on the skin
Usually, the procedure takes less than 20 minutes, and you can go home the same day.
How effective is transforaminal injection?
Some patients report pain relief within 30 minutes after the injection, but pain may return a few hours later as the anesthetic wears off. Longer term relief usually begins in two to three days, once the steroid begins to work.
How long the pain relief lasts is different for each patient. For some, the relief lasts several months or longer. If the treatment works for you, you can have periodic injections to stay pain-free.
What are the risks?
The risk of complication from a transforaminal injection is low. You may have soreness at the injection site. Other short term side effects can include: Numb or weak legs, dizziness, headache, and muscle spasms. Rarely, complications include bleeding, infection, nerve damage, allergic reaction, and spinal headache can occur. The other risks of these injections may be directly related to the medications injected. Some of the potential side effects of steroids include elevated blood sugars, weight gain, arthritis, stomach ulcers, and transient decrease in immune system function. Patients should speak with their physician about risk assessment for the procedure in their individual situation.
Who should not have a transforaminal injection?
Patients who have an allergy to any anesthetic, are on blood thinning medications, are diabetic, have an active infection, or are pregnant should consult with the pain physician before receiving the procedure. There may be special instructions or lab testing or the procedure might need to be rescheduled.
What happens afterwards?
You can continue your regular diet and medications immediately. Do not drive or perform any rigorous activity for 24 hours. Take it easy. You can return to your normal activities the next day. It may take up to a week for the steroid to begin working. How long the pain relief lasts and how much the pain is relieved is different for each patient. For some, the relief lasts several months or longer. If the treatment works for you, you can have periodic injections to stay pain-free. It is important to discuss your response to transforaminal injections with your physician in order to plan future treatment options. If you don’t feel better within ten to fourteen days, see your doctor for more evaluation and to discuss different treatment options.
Is transforaminal injection right for you?
Transforaminal injection may be right for you if your back or leg pain has lasted longer than four weeks, is severe, or has not improved with other conservative measures. Contact us to find out more!
At PrairieShore™ Pain Center, our goal is to relieve your pain and improve your quality of life. If your primary physician has advised you to see a specialist for your pain, turn to us for help. To schedule your appointment, please contact us here or give us a call at (847) 883-0077.