Transforaminal Steroid Injection

A transforaminal steroid injection is an injection of medication in the special space around an irritated nerve root.

The medications used are a local anesthetic (such as lidocaine) and a steroid (such as cortisone) which is a strong anti-inflammatory medication.

Why do we do transforaminal steroid injections?

Your child's physician has determined that there is a specific nerve root that is irritated and inflamed that is causing back or leg pain. The irritation and inflammation can be due to problems such as a bulging disc, or arthritis. It can also be due to the chemical substances released from a diseased disc.

What is the purpose of the transforaminal steroid injection?

The purpose of the injection is to decrease nerve irritation and inflammation by injecting the medication into the area causing pain.

When will the medication begin to work?

We use local anesthetic to confirm placement of the steroid medication in the area that causes your child pain. The local anesthetic works quickly but is only short lasting. (Similar to the numbing effect after a dental procedure). Your child may not notice the pain relief from the steroid until about 48 hours after the procedure. It takes longer for the medication to begin to work however it lasts longer than the local anesthetic.

How many injections will my child need?

The amount of relief varies and depends upon the amount of inflammation present. If the inflammation is severe, it may take 1-3 injections. These are usually done every 2-4 weeks. You and your child's physician will decide what is best for your child.

  1. A nurse will call you several days before the procedure to review procedure and give specific instructions.
  2. You and your child will check in at the Radiology Department on the 1st floor of B building unless otherwise instructed.
  3. You and your child will be taken to a procedure room and your child will be asked to change into a hospital gown.
  4. Most patients lie on their stomach.
  5. Your child's skin will be cleaned with special cleaning solution and local anesthetic (numbing medicine) will be placed using a tiny needle.
  6. X-rays are frequently used to guide the needle into the proper place and the steroid is injected. X-ray dye is also used to observe the medication spread.
  7. After the medication is injected, your child will be permitted to roll onto his / her back and be brought to the pre-procedure room.
  8. You will be given follow-up instructions for your child when discharged.

There are several possible complications; however, the risk is extremely low. These include:

  • Infection
  • Bleeding
  • Nerve damage
  • Headache

You may find that your child's pain gets worse initially. Your child's physician may order a small amount of pain medication for the first 2 days until the steroid medicine begins to work. This occurs because placing a needle into an irritated area causes more irritation. After the steroids begin to work-- approximately 2 days -- your child's pain should improve. Approximately 3 days after the injection, an advance practice registered nurse will call to see how your child is doing. You can call us with questions or concerns at 513-636-7768.

Your child should not participate in any contact sports or running until advised by his / her doctor.

  • Fever
  • Pain in the leg that lasts more than a couple of days
  • Redness and swelling at the injection site

Last Updated 12/2013