Why Am I Being Offered this Procedure?

Your doctor suspects that your back or leg pain may be caused by inflammation or compression of nerve roots in the spine.
These roots exit through small holes (foramina), which can narrow over time or due to degeneration. This can cause irritation and compression of the nerve roots, resulting in pain, tingling, or numbness.
A herniated disc can also compress a nerve root and cause similar symptoms.

Transforaminal epidural injection is a targeted treatment to reduce inflammation and pain, while also helping to identify the involved nerve.

What is a Transforaminal Epidural Injection?

It is an injection near the exit point of the affected nerve, which combines:

• Local anesthetic: to see immediately if the pain is reduced, and to better understand where the pain is coming from (diagnostic test)
• Cortisone: to decrease inflammation

This procedure has both a diagnostic and therapeutic purpose.

Before the Procedure: What to Know

Inform your pain specialist if:

• You have a fever or feel unwell
• You have allergies to medications, local anesthetics, or contrast agents
• You are taking anticoagulant medications (they may need to be suspended)
• You are pregnant (the procedure uses X-rays and will be postponed)

How to Prepare

• You may take your usual medications, unless otherwise instructed for anticoagulants.
• It is an outpatient procedure: hospitalization is not required.
• You will not be able to drive after the procedure: arrange for someone to accompany you.

How is the Procedure Performed?

• You will lie face down on an examination table.
• The skin is disinfected and prepared in a sterile manner.
• The skin is anesthetized with a local anesthetic.
• The doctor inserts a thin needle near the nerve root, guided by X-ray.
• A small amount of contrast medium is used to confirm the correct position.
• The anesthetic and cortisone are injected.

Duration: approximately 15 minutes.
After a short rest, you can return home (with an escort).

What Happens Afterwards?

• Immediately after, you might feel an improvement thanks to the anesthetic.
• It is normal to feel some numbness or heaviness along the leg.
• In the first few days, there may be a slight temporary worsening of symptoms.
• The full effect of the cortisone begins after approximately 10-14 days.

In most cases, only one day of rest is needed after a minimally invasive procedure.

We will ask you to fill out a simple form to evaluate the effectiveness of the procedure.

How Long Do the Benefits Last?

It depends on the cause of the pain:

• In some cases, a single infiltration provides lasting relief.
• In others, it may be necessary to repeat the treatment or consider other therapies.

Are there Risks or Side Effects?

The procedure is generally safe. Possible side effects include:

• Slight pain or discomfort at the injection site
• Temporary feeling of numbness
• Rarely, infection, allergic reaction, bleeding, or nerve injury (damage to a nerve)
• Temporary effects of cortisone (flushing, sweating, palpitations)
• In diabetic patients, a possible temporary increase in blood sugar

Serious complications are very rare.

Remember:

• Do not drive for 24 hours after the procedure.
• Arrange for someone to accompany you.
• Carefully fill out the form that will be given to you and return it to your pain doctor.