Spinal Pain Management

Epidural steroid injection or nerve block

A transforaminal epidural steroid injection or nerve root block is a procedure designed to alleviate pain caused by spinal nerve irritation. Usually the nerve is irritated to due degenerative disease of the disc. This could be from direct compression in cases of disc herniation or could be from inflammation due to disc arthritis.

In a transforaminal epidural steroid injection, a small needle is navigated through the skin and into the intervertebral foramen, the location where the spinal nerve exits the vertebra. There, the needle is placed either at the nerve covering (for a nerve root block) or in a space where the nerve travels, called the epidural space (for an epidural injection). The injection consists of a mixture of anti-inflammatory medication, short acting and long acting anesthetic.

If the patient’s pain is caused by the nerve, the resulting relief is usually immediate. Long term results may vary. Some patients will exhibit long term relief. More commonly, pain may return within 2 to 3 months or so. The injection can be repeated after 2 to 3 months if it was effective.