Transforaminal Epidural Steroid Injection (TFESI) FAQs

What Is a TFESI?

A TFESI consists of the injection of an anesthetic and a steroid into the epidural space to relieve inflammation causing back or neck pain. A TFESI does not cure the condition, but it can offer pain relief and aid in the accurate diagnosis of the problem.

How Long Does a TFESI Take?

The procedure takes between 15 and 30 minutes, with the actual injection taking 5 to 10 minutes.

Is a TFESI Painful?

A TFESI involves a needle penetrating the skin and tissues, so it can hurt. However, while you may experience some pain at the injection site, a local numbing agent given at the time of the injection minimizes discomfort. This makes the actual injection feel more like strong pressure than sharp pain. If necessary, intravenous sedation is available to block any pain from the injection. You are not “put under” for this procedure.

How Long Does It Take for The Medication to Work?

Because patients receive an anesthetic prior to the injection, temporary pain relief may last for several hours. The TFESI may not start working to relieve pain for up to 10 days, and during that period, pain may increase. That is normal.

TFESI should relieve pain for periods ranging from several weeks to several months, depending on the patient.

Are There Any Restrictions After the Procedure?

You must have someone to drive you home post-procedure and you should not drive anywhere else for the rest of the day. Do not take a bath, use a hot tub, go swimming or otherwise immerse in water for the rest of the day after the procedure. Do not place any type of heat over the injection site for 24 hours. Most patients can return to work the day following the procedure.

How Many TFESI Injections Will I Need?

Some patients find relief with one injection, but it is not uncommon for patients to require more than one injection.

How Often May I Receive TFESI Injections?

Patients are limited to only a few injections annually. More injections run the risk of harming the adrenal glands.

What Are TFESI Side Effects?

TFESI is a relatively safe process, but there are risks of side effects with any procedure. A small number of patients may experience headache, dizziness or nausea and vomiting. Call our office immediately if you experience severe pain, a headache that does not go away after taking over-the-counter headache medication, any weakness or numbness in your arms and legs or if you spike a temperature above 100.5 degrees. Also contact us if you develop any signs of infection, such as redness, heat, swelling or discharge. The steroids may cause temporary weight gain in some patients.

Are There any Contraindications for TFESI?

Patients with local or systemic infections should not receive TFESI. Anyone taking blood thinners should not receive an injection, nor should anyone with a history of allergic reactions to steroid medications.

A person diagnosed with or suspected of having acute spinal cord compression should not receive TFESI. Diabetic patients require careful monitoring, as the steroid may temporarily raise blood glucose levels.

Patients diagnosed with congestive heart failure may experience fluid retention due to steroids. Those with compromised immune systems may require laboratory testing and antibiotics prior to undergoing TFESI.