Do you also have frequent back pain? Or do you have a condition like 'Sciatica', which is a pain that goes from the back to the legs, like a current, or comes with a tingling sensation? Sometimes it can also be a pain that goes from the neck to the arms. Due to such pain, you must be very uncomfortable and unable to do your daily tasks properly. So, today we are going to talk about a very advanced and successful treatment method that allows you to control such pain.
What is this Transforaminal Epidural Steroid Injection?
Although this name may seem a bit complicated, its meaning is very simple. Let's break down the words.
- Transforaminal: This means "through the foramen." Think about it, the spinal cord, the main nerve root that comes from the brain, runs through our spine. There are small holes between the vertebrae for the nerves that go to different parts of the body to come out of this spinal cord. Those holes are called `foramina.` So this injection is given through that hole.
- Epidural: Our spinal cord is surrounded by a thick protective membrane called the `dura mater`. `Epidural` is the name given to the space outside that membrane.
Simply put, a Transforaminal Epidural Steroid Injection is a procedure in which a needle is inserted through the hole (foramen) where a spinal nerve exits, and a mixture of steroid and anesthetic medication is injected into the protective space around the spinal cord (epidural space).
The important thing is that this is not an injection directly into the spinal cord or nerves. The medicine is injected into a safe space around them. What this medicine does is reduce the swelling and inflammation around the nerve that is causing the pain.
What conditions is this treatment suitable for?
There are a number of reasons why your doctor may recommend this treatment. Most often, it is used to control pain caused by a pinched or injured nerve in the spine.
| Medical condition | A simple explanation |
|---|---|
| Lower back pain | Frequent and life-threatening back pain. |
| Sciatica | Severe pain, numbness, or burning that radiates from the back through the buttocks down the leg. |
| Herniated Disc | A jelly-like part of the spinal cord that protrudes and presses on a nerve. |
| Spinal Stenosis | Nerve compression due to narrowing of the spinal canal with age. |
| Pinched Nerve | Pain and numbness caused by a pinched nerve due to bone or other causes. |
| Bone spurs | Nerve compression due to new bone formation in the spine. |
Does this treatment treat different parts of the spine?
Yes. Depending on the location of the pain, this injection can be given to different parts of the spine.
- Lumbar injection: This is given into the lower back. This is what many people do for back pain and sciatica pain that goes down their legs.
- Thoracic injection: This is done for pain caused by a nerve in the middle of the back, for example, pain that radiates to the chest or abdomen.
- Cervical Injection: This is done in the neck area. This treatment is very effective for pain that radiates from the neck down the shoulder to the arm.
How is this treatment performed? Does it hurt a lot?
There is no reason to be afraid of this. This process happens like this.
1. Preparation: You will be laid on your stomach on a special bed with an X-ray machine.
2. Numbness: Before giving the injection, the doctor will inject a small amount of anesthetic into your skin to numb the area. You may feel a slight burning sensation at this point, but it will go away in a few seconds.
3. Sedation: If you want, you can have a sedative given to you through a vein in your arm to help reduce anxiety and increase comfort. This will make you drowsy, but you will still be awake. You can also talk to your doctor.
4. X-ray guidance: The special thing about this treatment is that it is done under X-ray guidance (Fluoroscopy) . This means that the doctor can see the inside of your spine like a live video. Therefore, this is done by looking exactly where the needle is inserted.
5. Giving the injection: While looking at the X-ray, the doctor carefully inserts a thin, long needle into the area of the nerve that is causing the pain. Then, a mixture of steroids and anesthetic is injected.
The entire procedure takes about 30 minutes . You won't feel much pain because of the numbing, but you may feel a slight push when the needle is inserted.
What should you be careful about after the injection?
After treatment, you can eat, drink, and take your medications as normal. But be careful with these things.
- Do not drive for 12 hours after the treatment.
- Don't do strenuous exercise or heavy lifting for a day.
- You can return to your normal activities from the next day.
It can take 24-48 hours for the steroid to take effect. It may take up to two weeks for the full effect to be felt. If the pain does not subside after two weeks, see your doctor again to discuss the issue.
How long does the effect of this treatment last?
This varies from person to person. Some people experience pain relief for a few weeks to a few months . If this treatment is successful for you, you can get these injections as often as needed to control your pain. It is generally considered safe to get between 3-6 injections per year. However, your doctor is the best person to decide.
Side effects and things to watch out for
The risk of serious complications from this treatment is very low. It is very safe because it is performed under X-ray guidance. However, there are some minor side effects that can occur rarely.
- Slight tingling or weakness in the legs or arms.
- Dizziness.
- Headache.
These usually disappear completely within a few hours.
| If you have these symptoms, call your doctor immediately. | |
|---|---|
| 1. | If numbness or weakness in the limbs lasts more than a day. |
| 2. | If you experience new pain that was not present before the injection. |
| 3. | If the pain worsens. |
| 4. | If you develop signs of infection such as swelling, redness, warmth, or fever at the injection site. |
Living with chronic pain caused by conditions like sciatica and herniated discs can be difficult. This treatment, called a Transforaminal Epidural Steroid Injection, can significantly improve your quality of life by treating the nerve that is causing the pain.
Take-Home Message
- Transforaminal Epidural Steroid Injection is a very accurate and safe treatment method to reduce pain and swelling caused by spinal nerve compression.
- Because this treatment is performed under X-ray guidance, it is possible to deliver the medicine exactly where it is needed.
- This is a treatment that provides relief by controlling pain and allowing you to carry out daily activities more easily, rather than completely curing the disease.
- Pain relief varies from person to person and can last from a few weeks to a few months.
- Talk to your doctor about whether this treatment is right for you and its benefits to make the best decision.
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