Transforaminal Injections

A lumbar transforaminal epidural steroid injection refers to a long-term steroid injection into an opening on the side of your spine where a key nerve root naturally exits, which is called a foramen. For a short distance, a tiny sleeve of epidural space extends beyond the nerve root. This unique sleeve is located just outside of the actual spinal canal.

These steroid injections are helpful in many circumstances for treating back pain and lower back pain. Epidural injections could be helpful in relieving some of the inflammation that comes along with herniated discs, allowing them to heal more quickly.


You won’t have to stay overnight to have this procedure done. It generally is not painful, so you will not need to be sedated for the injection. You will be laid facing down on a standard x-ray table and the skin above the area being treated will be numbed. Generally, you won’t feel anything at all. The numbing agents used for the skin are very similar to those used in dentistry to numb your gums or mouth.

The needle is inserted into the skin. When needed, a fluoroscope is used to guide the needle to the precise location. These types of injections are sometimes called root sleeve blocks, transforaminal epidural blocks, or root blocks.

Recovery Process

After the procedure, you will stay with us so that we can monitor you for about a half-hour. This will ensure you don’t have any negative reaction to the medications or placement of the needle. You will be asked not to drive for the rest of the day. Local anesthetic can dull the reflexes and lessen your response time temporarily.

You should be able to return to normal daily activities the following day. You may continue to feel some soreness or tenderness around the area where the injection was done. This is temporary and can be relieved with an ice-pack.

You will begin to feel pain relief in 2-3 days.

What to Expect From Transforaminal Injections

A transforaminal injection includes injecting a needle through your skin and down into your deeper tissues underneath. Although you may experience a bit of pain, the doctor can numb both the deeper tissues and surrounding skin using a local anesthetic with a super-thin needle prior to inserting the needle itself. Once the area is completely numb, the injection needle is inserted and typically feels more like pressure rather than actual pinching, without any sharp pain. Some patients choose intravenous sedation over a local anesthetic that makes the process much easier for them to endure. A number of patients undergo the injection without anything and do quite well overall.

Immediately following the transforaminal injection, your leg or arm may feel numb or slightly heavy, depending on the actual location of the injection and the amount of local anesthetic used. Nevertheless, regardless of the numb feeling, the majority of patients can still move their leg or arm just fine. This odd side effect stems from the concentration used rather than the amount of the local anesthetic itself. Also, many patients readily notice that their level of pain is significantly less or even gone. This instantaneous effect is also because of the injection of local anesthetic and will likely only last a couple of hours at most. You may experience some aching or soreness for a few days due to the needle insertion along with the initial irritation of the injected medications. Starting around the third day, expect to begin noticing substantial pain relief.

V. K. Puppala, M.D. cares for all his patients with empathy, kindness, and respect in the Metro Atlanta, Georgia area. Dr. Puppala takes a very unique and different approach to effective pain management by implementing a number of minimally invasive pain interventional methods by means of useful restoration and effective overall pain medication management. Call 770-627-7246 or 770-MAP-PAIN today to set up an appointment.

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Contact Us Today

Call 770-627-7246 or 770-MAP-PAIN to schedule an appointment today with Dr. Puppala at his practice in Lithia Springs, Georgia.