Lumbar Transforaminal Epidural Steroid Injection

Lumbar Transforaminal Epidural Steroid Injections are carried out to remove pain in the lower back as well as pain radiating down the legs. Steroid medications reduce swelling and inflammation caused by spinal channel narrowing, radiculopathy, sciatica and vertebral disc protrusion. In some cases it is necessary to repeat Lumbar Transforaminal Epidural Steroid Injection up to three times to get the maximum effect from the medication; however, most of the patients get substantial pain relief after one or two injections.

During the Lumbar Transforaminal Epidural Steroid Injection the patient lies face down with a soft pad under the stomach for comfort and to help relax the spine. Positioning of the spine gives easy access to the epidural cavity. The addition of fluoroscopy helps to find the specific lumbar vertebrae and nerve roots. At the injection site a local anesthetic is used first, which numbs the tissue down to the surface of the vertebra. Under fluoroscopy the doctor introduces a thin needle in the foraminal space near the nerve ending. Contrast is then injected to help verify the correct position of the needle. Then a mixture of steroids and anesthestics is introduced into the foraminal epidural cavity which soothes the painful nerve ending. After the needle is removed a small band-aid covers the injection site.


Possible side effects could be compared with common injection side effects, i.e. allergic reaction, bacterial infection, or bleeding in seldom cases. Steroid side effects are facial, eyes, arms, or legs swelling and elevated sugars for diabetic patients.

It is very important that the patient inform the physician about pregnancy or if he/she is taking blood thinning medication.