Epidural Steroid Injections

Transforaminal Epidural Injection

Transforaminal Epidural Injection is a procedure used to treat spinal pain. This injection can also be used to diagnose the specific source of pain. The pain is usually caused by inflammation due to irritation from disc herniation or rupture, spinal stenosis (narrowing of the spinal canal) or foraminal stenosis (narrowing of the nerve exit from the spine). The procedure involves injecting anti-inflammatory (steroid) medication and local anesthetic in the epidural space. These injections are much more specific targeting the cause of pain, smaller bore needle, smaller amount of medications, and have much more superior results. These procedures are very technical and Dr. El Abd is known in the Boston area for performing these procedures. Complications are rare, but can include pain, infection, blood pressure changes, headache, or neural injury. Dr. El Abd published research and lectures nationally and internationally about the proper techniques to perform these injections and on complications prevention. You may require a ride home if you require premedication such as valium. Many patients experience pain relief for a sustained duration for about a year or longer.

When you arrive, the staff will obtain a description of your pain and how you are managing daily activities. Medications, allergies and a brief health history will be reviewed. It is important to inform us if you have allergies to contrast (dye), Betadine, shellfish or latex, if you are taking blood thinners, such as Eliquis, Xarelto, Pradaxa, Coumadin, Plavix, Aggrenox, Pradaxa or Lovenox, if you have diabetes or if there is a possibility of pregnancy.

After discussing treatment, you will go to the procedure room where you will be helped onto the x-ray table into the best position for visualizing your spine. We will try to make you as comfortable as possible. Your skin will be cleansed with antiseptic, Dr. El Abd will place a small needle using fluoroscopic guidance. A small amount of contrast dye will be injected to confirm the proper needle placement, local anesthetic and steroid are injected afterwards. The entire procedure will take usually less than a couple of minutes.

The anesthetic can make your arm or leg (legs) feel weak or numb so plan to stay with us for about 15-20 minutes after your procedure. The staff will be available to answer any questions you might have and to review discharge instructions and follow up care.

When you go home:

  • Activity: rest and avoid activities that might aggravate your pain. You can usually return to work that day and resume exercising the next day if you do not experience discomfort.
  • Pain: Ice will help with localized discomfort from the injections for the first 48 hours, as will taking your normal pain medication. Most people will notice an improvement in 3-7 days.
  • Follow-up: You may be asked to follow-up with your physician or to repeat the injection in 2-3 weeks.

Many patients will have pain relief after the first injection. If this occurs, you do not need to repeat the injection and you can call us to cancel any repeat injection appointments.

For any questions please call the office 781-489-5541.