There is a fluid-filled sac that covers the spine cord called the dura. The space that surrounds the dura is called the epidural space, and it is filled with fat and small blood vessels. The foraminae are small openings between your vertebrae through which the nerve roots exit the spinal canal and enter the body.

An epidural steroid injection is a common type of injection that is given to provide relief from certain types of low back and neck pain.  The transforaminal approach is a very selective diagnostic injection around a specific nerve root.  By injecting medication around a specific nerve root, the doctor can determine if this is causing your problem. An anti-inflammatory steroid medication and local anesthetic is injected into the space.  The steroid agent shrinks swelling around the nerve roots and the local anesthetic numbs the inflamed areas and relaxes the muscles around the space. To ensure proper placement of the medication, the procedure will be performed under x-ray.

Some risks, although remote include:  bleeding, infection, nerve injury, and allergic reaction to the medication(s).  Diabetics may have short-term elevation of blood sugars.  People prone to fluid retention may have increased fluid retention for 1-2 weeks.

During the injection, your pain will be increased temporarily.  You may get 4-6 hours of pain relief immediately after the injection, however your pain will return and you may have more pain than usual for 5-6 days afterwards.

Upon registering at Southwest Ohio Pain Center, we will begin your procedure.  An IV will be started and you may be given medication for relaxation if you so desire.  The injection area will be cleansed with an anti-septic solution and numbed with anesthetic.  The doctor will insert the needle into the transforaminal space.  The procedure takes about 30 minutes.

You may apply ice to the affected area for 20 minutes every 2 hours. After the first day, you can perform activities as before & return to work.

Relief varies from one person to the next. The only way to know if it will work for you is to have it performed.  The steroid may take several days to work and peaks in about 2 weeks.  Therefore, it may be several weeks before you feel a change in your pain.  You may apply ice to the affected area for 20 minutes every 2 hours to decrease local tenderness.  After the first day, you can perform activities as before and return to work.

You may NOT drive for the remainder of the day after your procedure.  No heat is to be used on the injection area for the remainder of the day.  No tub bath or soaking in water (pools/Jacuzzi, etc) for the remainder of the day.

If you experience severe back pain, new numbness or weakness of your legs, loss of control of your bladder or bowels, or have signs of infection (temperature greater than 99.9º , drainage, redness/heat at insertion site) – call IMMEDIATELY.


♦ Take all blood pressure pills & heart medications prior to the procedure with a sip of water at least 3 hours before your requested arrival time. Your vitals must be stable to have the procedure.

♦ Have a responsible person to take you home.

♦ Arrive at the requested procedure time.  Please do not be late or your procedure may be cancelled. 


♦ Do not take ANY of the following 5 days before your procedure:  Coumadin

♦ Do not take ANY of the following 7 days before your procedure:  Plavix

♦ Coumadin must be stopped prior to the injection. You must have a normal INR prior to the injection.  Do not stop the drug by yourself.

♦ Eat or drink 6 hours before the procedure.


  • You have an active infection, flu, cold, fever, or very high blood pressure.
  • You do not have a responsible driver to take you home, arrive late for your procedure, or unable to follow the medication / fluid restrictions.

Call the office at (513) 860-1039 for procedure related questions.