Understanding Pain Control via Transforaminal Injections

A man stretches his arms over his head as he prepares for a run outdoors.

People in search of relief from neck or back pain, fellowship trained pain management specialists can provide pain management treatments such as a transforaminal injection. A transforaminal injection is a steroid injection used to treat patients with a pinched nerve. Conditions such as arthritis, bone spurs, or a motor vehicle accident can reduce the radius of the foramina which is a hole between the vertebrae that the nerve roots branch off the spinal cord and travel throughout the body. When bone or tissue presses against these nerve roots, they can become irritated and painful.

While injection treatments are not a good fit for everyone, some patients experience months of pain relief or even permanent pain relief. The Centers for Neurosurgery, Spine & Orthopedics, which serves patients in the Northern New Jersey area, explains how transforaminal injections work and which types of patients benefit.

What Is a Transforaminal Injection?

When a nerve root of the spine is compressed or irritated, pain radiates down one extremity. It sometimes is accompanied by numbness, weakness, or tingling. Pain, numbness, weakness, or tingling sensations along the same area of an extremity is referred to as radiculopathy. By minimizing the inflammation around the affected nerves, an injection treatment can provide significant pain relief. A transforaminal injection places a very small amounts of steroids near an inflamed nerve or nearby disc. This is done under fluoroscopic guidance by a pain management doctor. Transforaminal injections minimize the dose of steroids and limit any systemic effects.

Transforaminal injections are safe and minimally invasive. They are a non-surgical option for treating a bone structure abnormality that failed acute or chronic pain management conservative treatment. Patients with severe, persistent back pain that does not resolve with conservative treatment may need spine surgery. There are other forms of neck or back pain that do not have radiating or radicular pain that are treated with different types of pain management procedures such as a medial branch block.

Where and How is the Transforaminal Procedure Completed

A transforaminal injection can be performed in an outpatient setting of a surgical center or office-based setting and takes just a few minutes. Normally it is performed without general anesthesia or IV sedation. Only if the patient insists on IV sedation does the patient then need to refrain from eating or drinking before the procedure. In either instance, certain medications may need to be withheld 1-7 days before the procedure, depending on the medication. These medications are what are commonly known as “blood thinners”.

To administer the injection, a pain management doctor will numb the area of the back with a local anesthetic. This doctor will then painlessly place a very small needle into the area near the nerve root that is irritated and inflamed in the foramina. As the name would suggests, this is what is called a transforaminal injection. It is performed using fluoroscopic guidance (real-time X-ray equipment) to ensure the medication is delivered in the precise location. The injection includes both a local anesthetic and a small dose of steroids.

Many patients will feel pain relief immediately from the anesthetic, which wears off after four to five hours. The steroid takes a few days to work, but it can provide more long-term pain relief. Though each patient responds to treatment differently, the effects of a transforaminal injection can permanently resolve the discomfort. If the discomfort should return, the injection can be performed again and may have longer lasting relief.

Patients will need somebody to drive them home afterward, but most patients can return to work the following day. Any side effects from the injection usually are very minor. A pain management doctor will recommend combining injection treatments with rehabilitation to assist in improving the recovery and strengthening of the surrounding muscles to prevent a recurrence. Injections are more effective when coupled with exercise and ergonomic adjustments.

What Conditions Can Be Treated With a Transforaminal Injection?

Before recommending a pain management injection procedure, doctors will have a patient try more conservative treatment methods, such as applying heat or ice, using oral pain medication, and physical therapy. The majority of back pain is resolved using these conservative methods.

If a patient still has persistent radiculopathy and back pain after these treatments, they may be a candidate for a steroid injection such as an epidural or transforaminal injection. These injections can be used to reduce acute or chronic back discomfortable symptoms caused by spine conditions including:

Find Expert Pain Management Specialists at CNSO

Patients seeking an experienced provider for transforaminal injections can count on the Centers for Neurosurgery, Spine & Orthopedics (CNSO). Located in Northern New Jersey, CNSO is the most comprehensive brain, spine, and musculoskeletal center in the state. At CNSO, patients will find award-winning neurosurgeons, pain management specialists, orthopedists, physical therapists, exercise and rehabilitation specialists under one roof at each of our six locations. Every facility provides a holistic approach to patient care. The medical staff excels at finding opiate-free pain treatment to help patients get back to doing the activities they love. For more information about CNSO’s services, contact the office today.

Centers for Neurosurgery Spine & Orthopedics
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