What Is a Transforaminal Epidural Injection

What Is a Transforaminal Epidural?

Epidurals are injections that typically involve steroids and aim to relieve pain in a problem area. In addition to removing pain, they also help improve mobility. The idea is that epidurals can provide these benefits without surgical interference, reducing the risk. A transforaminal epidural is an epidural injected into a specific part of the body.

The Basic Definition

With a transforaminal epidural injection, your doctor inserts a small-gauge blunt needle into your epidural area. This is done via the bony opening, where the root nerve exits.

This is a common treatment for people dealing with pain in their legs and/or back. That pain may be due to car accidents, work-related accidents, slip and falls, degenerative spine problems, or something else.

As mentioned, the goal of a transforaminal epidural is to reduce pain and improve mobility without surgery. You may have this type of injection in hopes of altogether avoiding surgery. Or, you may have it to delay surgery.

The Procedure

You are awake but sedated during a transforaminal epidural. You need to be awake since you will need to talk to your doctor during it. Most importantly, your doctor needs to confirm that the needle’s placement doesn’t cause significant leg pain.

With a transforaminal epidural, the needle is smaller than those used in conventional epidurals. You lay on your belly during the procedure. Your doctor uses real-time X-ray guidance with radiopaque dye injected to enhance the images. This guidance prevents accidentally damaging your nerve root.

Using a smaller needle, the guidance, and the entry point of a transforaminal epidural lets the doctor get closer to the nerve root that is irritated. This is compared with a traditional interlaminar epidural.

Conditions Treated

 Your pain management doctor will let you know if a transforaminal epidural is likely to improve your condition. This type of steroid injection is commonly used for lateral disc herniations, foraminal stenosis, and large disc herniations. For reference, five to 20 people out of 1,000 adults have herniated discs.


A transforaminal epidural is an outpatient procedure. The medical staff will monitor you for at least half an hour after the procedure. Someone needs to be with you, as you aren’t allowed to drive or operate heavy machinery after the injection. You also can’t soak in the water or swim that day.

If the insertion site hurts, feel free to use an ice pack. You should be able to work the next day.


According to Spine Universe, transforaminal epidurals have long-term success rates of between 71 and 84 percent. Those who have the epidural to deal with leg pain and disc herniation reach their maximum improvement in about six weeks.

It is rare for patients to experience complications after a transforaminal epidural. Even so, you may notice discomfort at the insertion site, bleeding, blood pressure changes, headaches, or infections. Although very rare, steroid injections can also cause increases in blood pressure and blood sugar and/or leg swelling. It is incredibly rare for your nerve root to be damaged during the procedure.

Interestingly, if you don’t get much relief from the first transforaminal epidural, you aren’t likely to experience more relief if you repeat the injection.

At New York Spine Specialist, we treat patients for neck and back pain after an injury or accident. If you are experiencing pain, call us to make an appointment at (516) 355-0111. Our pain management doctors accept workers’ compensation, no-fault, and other insurance plans. We are here to help and offer the right treatment for your condition.