A lumber transforaminal epidural steroid injection (TFESI), is an injection of corticosteroids—a type of drug that reduces inflammation—in the lower back into a space just outside the covering of the spinal cord.
The procedure is sometimes used when compression or inflammation of nerves in the lower spine are causing pain, weakness, or numbness. During a TFESI, your medical team will inject this medicine directly onto spinal nerves to help relieve pain.
You will be lying on your back for the procedure. Your doctor will inject a local anesthetic into your skin to numb it. Then, using a type of live X-ray called fluoroscopy for guidance, the doctor will carefully insert a thin needle to an area just behind the nerve root.
Then they'll inject a small amount of contrast dye so they can be sure that the medicine will spread to the area where it's needed. Next, they'll inject the corticosteroid, and in some cases a small amount of anesthetic.
You will stay in the surgical center for 15-20 minutes while medical staff check your vital signs, such as blood pressure and pulse. You can go home once you're stable, but you'll need to have someone to drive you and should plan on taking it easy the rest of the day.
You may feel some numbness the rest of the day and may have soreness at the injection site for a day or two. It usually takes one to three days before the medication takes effect and it may be a week before you feel the full benefit of the injection. People sometimes need more than one injection to control the pain.
The risk are low. Some patients experience side effects from the medication, including insomnia, flushed face, low-grade fever, headache, or fluid retention. Other possible risks include an allergic reaction to the contrast dye or the anesthesia, bleeding from the needle hitting a blood vessel, and irritation in the injected area. Serious complications such as neurological damage are rare.
If you have a herniated disc, radiculopathy, or radiculitis and other treatments aren't providing enough pain relief, TFESI may be a good option. The technique is used when problems with a specific spinal nerve (or nerves) is believed to be causing the pain.
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