Transforaminal Epidural Steroid Injections


Patients with pain caused in the nerve roots in the spine affecting the cervical spine (neck), the thoracic (chest) and the lumbar (low back) are sometimes treated with a selective nerve root block. This minimally invasive procedure uses a steroid medication and a numbing agent to reduce pain and treat inflammation around the nerve roots in the spine. The selective nerve root block is sometimes used to isolate the cause of the pain prior to using other pain therapies such as radiofrequency ablation. Additional pain management treatments may not be necessary however if adequate pain relief is achieved from a selective root block.


In this procedure, the patient is face down with the back exposed. To treat anxiety or physical discomfort throughout the procedure, the patient may be given intravenous sedation (IV). The skin is prepared with an antiseptic wash and a local anesthetic is injected for skin analgesia. The physician will use an X-ray device to inject the through the needle into the neuroforaminal space. A contrast dye will be introduced to verify the correct needle positioning. Finally, a combination of steroid medication and an anesthetic will be injected into the neuroforaminal space treating the damaged nerve roots. Before removing the needle, the physician will treat all of the affected areas and then the patient will have a short time in the recovery area.

After Care

In the recovery area, our medical team monitors the patient’s blood pressure, respiration, oxygen saturation, temperature, and heart rate. Heaviness or numbness in the arms and legs are common after the procedure due to the anesthetic. Within a few hours, these after-effects will subside. A caretaker will be needed to help the patient get home following the selective nerve root block. For some, symptoms should significantly decrease within a few days, for others it will take a few weeks. Alternate therapies may need to be considered it the patient does not experience any significant changes in his or her pain levels.