Cervical Transforaminal Epidural Steroid Injection

A Cervical Transforaminal Epidural Steroid Injection (TFESI) is a targeted, minimally invasive procedure that delivers anti-inflammatory medication directly to irritated nerve roots in the neck. This approach can relieve pain that radiates from the cervical spine into the shoulders, arms, and hands—often caused by disc herniation, spinal stenosis, or nerve compression. By reducing inflammation and swelling around the affected nerve, this injection can ease pain, improve mobility, and help patients return to daily activities with greater comfort.

Quick Facts

  • Setting: Outpatient, image-guided
  • Time: ~20–30 minutes
  • Anesthesia: Local with optional light sedation
  • Recovery: Same-day discharge; mild soreness for 1–2 days
  • Duration of relief: Weeks to months; may be repeated as needed

Who it helps

  • Cervical disc herniation or bulging disc
  • Cervical spinal stenosis (nerve compression in the neck)
  • Foraminal narrowing causing arm or shoulder pain
  • Radiculopathy (nerve irritation causing tingling, burning, or weakness)
  • Chronic neck and arm pain not relieved by medication or therapy

How it works

Nerve roots in the cervical spine can become irritated or inflamed due to compression from a disc or narrowing of the spinal canal. During a cervical transforaminal epidural injection, your provider uses fluoroscopic (X-ray) guidance to precisely position a thin needle into the foramen—the small opening where the nerve exits the spine. A mixture of corticosteroid and anesthetic is then injected around the affected nerve, helping to reduce inflammation, swelling, and pain.

What to expect

  • Before: Your provider will review your medical history and imaging. You may need to stop certain medications (such as blood thinners) before the procedure.
  • During: You’ll lie comfortably on your stomach or side. The area is cleaned and numbed, and under real-time X-ray guidance, your provider positions the needle into the targeted foramen. Once confirmed, medication is slowly injected.
  • After: You’ll rest briefly for observation and can go home the same day. Mild soreness or a temporary increase in symptoms can occur before improvement begins within several days.

Benefits & risks

Benefits:

  • Delivers medication directly to the source of nerve irritation
  • Can reduce pain, numbness, and tingling in the neck, shoulder, and arm
  • Minimally invasive and outpatient-based
  • May help delay or avoid surgery for some patients

Risks:

  • Temporary increase in pain or numbness
  • Infection, bleeding, or headache (rare)
  • Nerve irritation or allergic reaction (rare, minimized with image guidance)

Is it right for me? (Checklist)

  • ✅ Neck and arm pain related to nerve compression or irritation
  • ✅ Confirmed findings of cervical disc herniation or stenosis on imaging
  • ✅ Pain that radiates or shoots down the arm
  • ✅ Persistent symptoms despite conservative treatment

Alternatives at PCET

FAQs

  • When will I notice relief? Many patients begin feeling improvement within 3–5 days as inflammation decreases.
  • How long does relief last? Relief may last weeks to months; additional injections can extend results.
  • Is it safe? When performed by an experienced, image-guided provider, the risk of complications is very low.
  • Can it prevent surgery? For some patients, injections help manage pain and delay or avoid the need for surgical intervention.
  • Is it covered by insurance? Most insurance plans, including Medicare, cover this procedure when medically indicated.

📞 Call to Schedule

Ready to learn whether a Cervical Transforaminal Epidural Steroid Injection could help relieve your neck and arm pain? Call (865) 579-0552 to schedule your appointment today.