If you have sciatica, herniated discs, or other back problems, a transforaminal injection can help alleviate the discomfort in your lower back, legs, and feet.
A network of nerves travels down your arms and legs from your spinal cord. When a damaged disc or another ailment irritates and inflames one of these nerve “roots” (the end closest to your spinal cord), it can cause pain to spread from your back to your legs and feet.
It helps lessen the inflammation and alleviate discomfort by taking a steroid medicine. The process involves injecting into your spine and spinal cord space.
Why do you need a transforaminal epidural steroid injection?
Five vertebrae make up the lumbar region of the spine. These vertebrae are stable due to the cushion of soft discs between them. Chemicals within a disc may spill if it rips. Inflammation of nerve roots or the dura can result in discomfort. This can induce a bulging disk, irritating nerves, or damage the dura, causing pain. Osteophytes, bony growths pushing on nearby nerve roots, can also produce discomfort.
How does transforaminal epidural steroid injection work?
Firstly, your physician will administer an intravenous sedative to you. You will then lie on your stomach on the x-ray table.
The doctor will apply a local anesthetic to a small piece of skin on your lower back. They will next use an x-ray to help guide the insertion of a tiny needle into your lower back, explicitly targeting the nerve root causing your discomfort.
Inject a combination of anesthetic and steroid into the affected area to alleviate any discomfort (for longer-term relief)
The average time to complete the treatment is around 20 minutes. This is not a long-term commitment.
When to do the procedure
If you lean over, the discs and nerves in your lower back may be inflammation. Nerve root irritation may cause discomfort down your legs as you bend your back.
Does transforaminal injection work?
The anesthetic may wear off within a few hours. However, some patients experience relief from pain within 30 minutes of receiving the injection. Once the steroid begins to work, longer-term relief often starts in two to three days.
Each patient uniquely experiences pain alleviation. Relief might persist for months or even years, depending on the individual. If the treatment is effective, periodic injections may be necessary to maintain pain-free status.
You will be lying face down on an X-ray table during the process. The surgeon may use cushions beneath your sternum to aid in placement. Fluoroscopy (live X-rays) will confirm that the patient is in the correct posture. A sterile drape will be put over the area of your low back to keep it clean while the treatment is being performed, after which an antiseptic solution will be applied. Your skin will next be anesthetically injected with a local anesthetic to numb it. Fluoroscopy (live X-rays) will then be used to guide the needle as it enters the epidural space via the dampened skin. You may feel coldness or increased pressure in your lower back, depending on where the needle is inserted into the epidural area. A small quantity of contrast is injected under a live X-ray after the hand is in the epidural space to guarantee that the drug will distribute adequately. During this injection, you’ll notice a rise in pressure. An epidural injection of corticosteroids will follow this. During this operation, it’s not uncommon to feel more pressure in the area being treated. You should notify your surgeon right away if the pressure gets unbearable. The needle will be removed, and the injection site will be covered with a bandage when the injection has been completed.
How to prepare for the procedure
Lumbar transforaminal epidural steroid injections at an ambulatory surgery facility are commonly performed as outpatient treatment. Before your procedure, you should fast for at least two hours without eating or drinking. All medications, except blood thinners, should be taken the day before the operation. All pharmaceutical questions should be sent to our office.
What’s next after transforaminal epidural steroid injection?
Diet and medicines can resume as usual immediately. For the next 24 hours, avoid driving or strenuous exercise. Take it slow. The next day, you can continue your routine activities.
For the steroid to begin functioning, it may take up to a week. Don’t wait more than ten days before seeing your doctor for an examination and treatment options.
Side effects of transforaminal injections
It’s pretty unlikely that a transforaminal injection will cause any harm. The injection site may get infected or bleeding in rare cases.
Among the possible side effects:
- Legs or feet that are numb or shaky
Most of these side effects go away in a few hours or days.