Man performing a back stretch without pain

Foraminal injections, also called transforaminal injections, are injections of steroid medication into the foramen that help alleviate pain in the lower back, the legs, and the feet. Intervertebral foramen, or neural foramen, are openings between vertebrae where nerve endings leave the spinal cord to travel to other parts of the body, like the legs and feet. The nerves in the spinal cord facilitate transmission of signals from the brain to the rest of the body. When one or more of these nerves become inflamed, it can cause pain somewhere in the body.

Why Foraminal Injections Are Performed

Transforaminal injections are used to reduce or eliminate inflammation in the nerve roots of specific vertebrae in order to treat various symptoms in the lower back and lower limbs, such as:

  • Tingling
  • Numbness
  • Pain

Nerve roots can become inflamed and swollen for many reasons, including:

Foraminal injections help individuals suffering from lower back and limb pain to regain mobility without surgery. This procedure can also be used to diagnose which specific nerve root is causing the individual’s pain. To diagnose the nerve that is causing the patient’s symptoms, the pain specialist will inject a local anesthetic onto a specific nerve and ask the patient about how the pain changes. The nerve responsible for the pain is identified when the anesthetic is delivered and pain subsides. This diagnostic process using foraminal injections allows pain specialists to determine the optimal location to deliver the steroid medication in order to relieve pain.

What to Expect During a Foraminal Injection Procedure

A transforaminal injection procedure generally takes about 20 minutes to complete. The patient is asked to lie down on an x-ray table on the stomach with a pillow underneath the abdomen. Before the procedure, the patient is given a medication via an IV to help him/her relax. The pain specialist then numbs the area with a topical anesthetic. He/she then uses x-ray images to guide the injection of the steroid medication into the inflamed nerve root.

Risks Associated with Foraminal Injections

Possible risks associated with transforaminal injections include bleeding or infection at the site of the injection. Some people may experience side effects such as:

  • Dizziness
  • Headache
  • Numbness in the legs or feet

Side effects typically pass within a few hours.

Benefits of Foraminal Injections

Foraminal injections provide temporary relief from pain in the legs and feet, during which time patients can work to to regain mobility with the help of a licensed physical therapist, without the need for surgery.

How to Prepare for a Foraminal Injection

When scheduling an appointment for a transforaminal injection, patients should discuss their medications with the care team. They may be advised to discontinue the use of certain medications, like blood thinners, a few days before the procedure to reduce the risk of complications. It’s important to follow all pre-procedure instructions given by the care team.

Post Foraminal Injection Treatment

Following a foraminal injection procedure, patients are not allowed to drive or do any vigorous activity for 24 hours. Patients are allowed to return to work and normal activity one day after the procedure.

Transforaminal injections do not provide permanent pain relief. Some individuals will experience pain relief for up to six months. However, periodic injections are necessary in order to maintain long-term pain and symptom relief.

Pain Management Locations

To find a pain management specialist,
call 844-333-DOCS (3627)

MedStar Washington Hospital Center

110 Irving Street, NW
Washington, DC 20010 

MedStar Health at Lafayette Centre
1133 21st St. NW
Washington, DC 20036

MedStar Health at Brandywine
13950 Brandywine Road
Suite 225
Brandywine, MD 20613