Lumbar Transforaminal Epidural Steroid Injection

This outpatient procedure is an injection of a steroid-anesthetic medication. The medication can reduce swelling and inflammation of irritated spinal nerves. This procedure is performed to relieve pain in the lower back and pain that radiates from the back to the legs. The injection takes only a few minutes to complete.

How is the procedure performed?

In preparation for the procedure, the patient lies face down. A cushion is placed under the abdomen, which causes the spine to bend in a way that opens the spaces on the sides of the spine. These spaces are called the foramina. A local anesthetic is administered to the numb skin and the tissue that covers the spine. When the area is numb, the physician carefully guides a needle into the foraminal space that surrounds the irritated nerve root. A contrast solution is injected through the needle. The physician uses a fluoroscope (a type of x-ray device) to confirm that the tip of the needle is positioned correctly.

After the needle’s position has been confirmed, the physician injects a steroid-anesthetic medication. This medication bathes the irritated nerve roots. It will help alleviate the patient’s pain. When the procedure is complete, the physician removes the needle and bandages the insertion site. The patient may feel relief after one injection. Some patients may need multiple injections before they feel the full benefit of the medication.

What are the risks?

Overall transforaminal injections are safe. However, with most invasive procedures there is a risk of infection, bleeding and allergic reactions to the medications used.

Will the injection hurt?

Since the injection involves inserted a needle into the skin and deeper tissue, there is some pain involved. The skin and tissues will be numbed with a local anesthetic before the injection. Many people experience a little stinging when the anesthetic is being injected. Once the tissues are numb, the transforaminal injection feels like a strong pressure or pinching, not necessarily a sharp pain. There is an option of an intravenous sedation that can help patients tolerate the procedure better.

How will I feel after the injection?

It may take a week or so for the medicine to take effect. Normally you will have a follow-up visit approximately two weeks following the procedure, so that you can discuss your response to the injection with your physician.

What restrictions will I have the day of the procedure?

You will not be able to drive after the procedure so it is recommended that transportation be arranged to and from the appointment for a lumbar transforaminal epidural steroid injection. The patient can resume normal activities on the following day, unless stated otherwise by the physician.

When should I call my doctor?

If you experience any of the following you should contact us right away.

  • Painful headaches while sitting or standing that feels better when lying down
  • Fever of 101 F or higher for more than 24 hours
  • New numbness or weakness
  • Any sign of infection around the injection site (redness, swelling, bleeding)
  • Loss of bladder or bowel control after the local anesthetic has worn off