Transforaminal Epidural (Lumbar)

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Why would I need a transforaminal epidural?

A transforaminal epidural can be injected into the spine in the neck, mid back or lower back. The procedure helps to relieve pain in these areas that haven’t responded to other pain relief treatments, and particularly where nerve impingement is involved.

What symptoms does a transforaminal epidural address?

Severe or persistent neck or back pain, especially when it goes into an arm or leg, can be eased with a transforaminal epidural. The anaesthetic used numbs the nerves that send pain signals to the brain and provides short term pain relief . The steroid helps to reduce the pain caused by swelling and inflammation. The injection can provide long term benefit.

Each patient reacts differently to this treatment, some may experience a significant reduction in pain; but, for others it might not be so pronounced. Some may experience a worsening of their symptoms before they get better.

When should you speak to your  specialist about having a transforaminal epidural?

If you have significant neck or back pain, especially if it is going into a limb, speak to your doctor about a referral to a specialist who may be able to carry out a transforaminal epidural. The specialist will need to see you to assess the relevance of this procedure to you.

How is a transforaminal epidural performed?

A transforaminal epidural is usually carried out as a day case procedure and you’ll be allowed home the same day. You should arrange for someone to drive you home afterwards and stay with you for the first night.

You may  have the procedure under sedation to make you feel comfortable and relaxed. Your doctor will also numb an  area of skin with a local anaesthetic. Your specialist  will use an x-ray and electrical stimulation to guide the injection into the correct position in your spine before administering the medication.

What is the recovery like for a transforaminal epidural?

Your recovery from having a transforaminal epidural will depend on multiple factors, including your age, fitness level and condition being treated.

You may feel weakness or numbness in the area when you recover from the sedation which can last a day or so. You may be advised to take pain relief medication for a few days following your procedure whilst the area settles down.

Are there any risks/complications associated with a transforaminal epidural?

As with any medical procedure, it’s possible for risks or complications to arise. Speaking with your specialist  beforehand will help you understand these.

A transforaminal epidural has a relatively low risk of serious complications happening, but the following can occur in a small number of cases:

• Short term increase in pain
• Tenderness and bruising at the treatment site
• Weakness or numbness in the treatment area and/or the upper or lower limbs
• Nerve or blood vessel damage
• Bleeding or infection at the treatment site

You may also experience a reaction to the steroids used, which may mean that you experience facial flushing, an upset stomach or a rise in blood pressure.

Where can I learn more about a transforaminal epidural?

It’s best to talk to your specialist  about having a transforaminal epidural, they will provide an in depth information leaflet as well. There are also online resources including NHS sources that can provide you with additional information.

How can I prepare for a transforaminal epidural?

Prior to having a transforaminal epidural, your surgeon will discuss with you how best to prepare, as each patient is different.

Common preparations for a transforaminal epidural include:

• Routine blood tests or scans as requested by your surgeon
• Taking steps to stop smoking if you smoke
• Losing weight if you’re overweight
• Remaining active and doing regular exercise

The specialist will advise you on eating and drinking restrictions prior to the injection

Are there alternatives for a transforaminal epidural?

You may decide that you’d rather continue to take pain relieving medications instead of having this procedure and or to work with pain management stratergies.