See how it is done
The transforaminal epidural injection is a more selective version of the standard epidural. Instead of bathing the whole epidural space in medication, we deliver the steroid right at the foramen — the small opening through which a specific nerve root exits the spine.
This approach is best when your MRI clearly shows a single nerve being pinched, or when a previous interlaminar injection helped only briefly. Available at cervical, thoracic, and lumbar levels.
What to expect
Performed under fluoroscopy. You lie on your stomach. After numbing the skin, we use the live X-ray to position a fine needle at the foramen, confirm placement with a small dose of contrast dye, and inject the steroid.
What this treats
- single-level radiculopathy
- foraminal stenosis
- disc herniation with nerve compression
- post-surgical radicular pain
Conditions this treats
Common diagnoses we use this procedure for. Tap one to read more.
Before, during, and after — what to do
Before your appointment
Eat a normal meal before your appointment — there is no fasting required for most injections. Take your usual medications unless we have specifically asked you not to. If you take a blood thinner (aspirin, warfarin, clopidogrel, apixaban, rivaroxaban, etc.), tell us in advance — we may need to adjust the timing. Bring your OHIP card and any imaging reports we asked for.
On the day
Wear loose, comfortable clothing — easy to roll up sleeves or pant legs, easy to lie face-down on the table. Plan to be at the clinic about 45 minutes total. You can drive yourself unless we told you otherwise. If you are anxious about the procedure, tell us — we will walk you through every step.
After the procedure
You may feel some soreness at the injection site for 1–3 days. Ice helps; so does Tylenol or ibuprofen if you can take it. Avoid heavy lifting or vigorous exercise for 24 hours, then resume normal activity as comfort allows. The therapeutic effect of the injection usually starts within a few days and reaches full strength by 2 weeks.
When to call us: Call us right away — or go to the nearest emergency department — if you develop a high fever, severe new pain, redness or swelling at the injection site, weakness in a limb, or loss of bladder or bowel control. These are rare but worth knowing.
What happens on the day
We use live fluoroscopy to see exactly where the needle is going. The procedure itself takes about 20 minutes, plus a little time to get you positioned and a short rest afterwards. Most people feel relief lasting 4 to 12 weeks.