Health Library

Epidural and Transforaminal Steroid Injections

Epidural and Transforaminal Steroid Injections

An epidural steroid injection is an administration of steroid through a needle. Sometimes a local anesthetic or numbing medication is also injected with the steroid.

There are two general approaches:

  • One is called interlaminar, which means the needle is inserted into the epidural space.
  • The second is called transforaminal, which means the medicine is injected in the space around an irritated nerve root.

The doctor performing the injection will choose which approach is best for your child.

Common Questions about Epidural Injections

Why do we do epidural steroid injections?

Epidural steroid injections are done when there is nerve irritation and swelling causing back or leg pain. This pain is often referred to as sciatica. The irritation and swelling can be caused by a problem such as a bulging disk or the chemical substances released from the injured disc or arthritis.

What is the purpose of the epidural steroid injection?

The epidural steroid injection will decrease nerve irritation and swelling. The doctor will inject the medication at the level of the back where the problem is located.

When will the medication begin to work?

We sometimes use local anesthetics to confirm placement of the steroid medication in the area that causes your child pain. The local anesthetic usually works quickly but only lasts a short time. It's similar to the numbing effect following a dental procedure. Your child may not notice the pain relief from the steroid until about three to six days 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 your child need?

Most children need one to three injections. These are usually done in two-week intervals. You and your child's physician will decide the best plan for him / her. The total amount of steroid medicine is monitored and kept to a minimum to help avoid side effects.

Epidural Injection Procedure

1. A nurse will call you several days before the procedure to review the procedure and give specific instructions.

2. If sedation is needed, that will be arranged ahead of time and provided by our colleagues in the Anesthesiology Department.

3. Most patients usually lie on their stomach for the procedure.

4. The skin will be cleaned with special cleaning solution, and the local anesthetic (numbing medicine) will be given using a tiny needle.

5. X-rays are used to guide the needle into position. X-ray dye may also be used to observe the medication spread. Once we are confident that the injection will be in the correct place, steroid is injected, then the needle removed.

6. After the medication is injected, your child will be permitted to roll on his/her back and will be watched for a short time before being allowed to go home. Your child will be discharged, and follow-up instructions will be given.

Possible Complications of Epidural Injection

There are several possible complications; however, the risk is extremely low. These include, but are not limited to, infection, bleeding, nerve damage and headache. If there is a known spinal problem, the risks may be greater, and the decision to offer the injection will be made among all of the specialists involved in your child’s care. If there is an infection near the area we need to enter with the needle, we will wait until the infection is treated.

After the Epidural Injection

Your child's pain may get worse for the first couple of days. This occurs because placing a needle and injecting steroid into an irritated area causes increased irritation. His/her doctor may order a small amount of pain medication for the first two days until the steroid medicine begins to work. After the steroids begin to work (approximately three to six days), your child's pain should improve. Approximately three days after the injection a nurse may call to see how your child is doing. You may also call 513-636-7768 with questions or concerns. Your child should not participate in contact sports until advised by his/her doctor.

Call Your Child's Doctor If:

  • Fever
  • Neck stiffness
  • Red or swollen injection site
  • Discharge from the injection site

Last Updated 10/2019

Contact us.

Find contact and referral information for the Pain Management Center.