Transforaminal and Selective Nerve Root Injections

Under x-ray guidance, a transforaminal or selective nerve root block involves injecting a combination of local anesthetic and steroid into the area where a nerve exits the spinal column. Typically, your doctor will recommend this block if you are experiencing arm or leg pain that follows a single nerve path. The block may serve as both a diagnostic and therapeutic tool.

There are three possible outcomes of a transforaminal or selective nerve root block:

  1. The pain does not go away, indicating that the source of the pain may not be related to the nerve at the injection site. This outcome can provide diagnostic value.
  2. The pain goes away for a few hours after the injection, but returns and does not improve. This result also has diagnostic value and suggests that the pain is coming from the nerve at the injection site, but the steroid was not effective.
  3. The pain goes away after the block, and while it may briefly return later that day, it gradually improves over the next few days. This outcome is therapeutic, indicating that the steroid had a lasting effect on the pain. If the patient experiences significant and lasting pain relief, the injection may be repeated. Additionally, the injection may be used to determine if surgery is a viable option and at what level it may be most effective.

Is It Effective?

After the injection, some patients may notice pain relief in as little as 30 minutes. However, it's common for the pain to return a few hours later as the anesthetic wears off. Typically, the longer-term relief starts within two to three days once the steroid begins to work. If stem cells and PRP are used, it can take four to six weeks for the pain relief to begin. The duration of pain relief can vary for each patient, with some experiencing relief for several months or longer.

In case, you suffer from chronic lower back or radiating pain down your legs, do not delay anymore. Call us to schedule an appointment with our specialists at Neuro Spine & Pain Center. We offer lumbar transforaminal epidural steroid injections and various other treatment modalities at our clinic in Key West.

What to Expect?

Upon your Arrival for the procedure, one of our nurses will discuss about how the back or neck pain feels like and how you manage day to day activities. The nurses will record the following vital health information:

  • Allergies
  • Weight
  • Blood pressure
  • Temperature
  • Brief health history
  • Medications you’re currently taking
  • Pulse

When You Go Home After Your Transforaminal Nerve Root Block

Once the procedure is over, it's important to take some time to rest and avoid any activities that could worsen your back or neck pain. Although you may be able to return to work on the same day, it's advisable to take it easy and not engage in any strenuous activities. If you experience any discomfort or pain, it's best to avoid exercise for the first day or two. However, if you don't experience any pain, you can resume your exercise routine on the following day.

After transforaminal nerve root block procedure, it is normal to experience mild discomfort or pain at the site of injection. This may persist for 48 hours. Doctors usually recommend application of ice to the affected area. Over-the-counter pain relief medications may also be directed by your doctor.

Relief from pain post a transforaminal nerve root block procedure may vary from one patient to another. Some patients may experience relief after just 1-2 injections while others may need up to 3 injections for relief. Immediate pain relief may not occur in some cases. Simply schedule a follow-up appointment with your doctor. This is important to receive additional injections in the future. In some cases, pain may persist. Other treatment options may help minimize discomfort.

Speak to your doctor for more information on receiving a referral for a transforaminal nerve root block. Reach us now at 305-296-2212 to schedule an appointment.

Best Spine Surgeons and Pain Specialists

Dr. William Schnapp

Board-certified Neurologist

Dr. Jon Gottlieb

Orthopedic Spine Surgeon

Dr. Doug Hollern

Orthopedic Spine Surgeon

Jorge Lerma, ARNP


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