A TFESI is an injection that can help relieve chronic and severe back pain caused by certain conditions when other treatments do not work. The shot is usually painless, and side effects are typically mild.

Transforaminal epidural steroid injection (TFESI) is a treatment for severe pain in your back related to various health conditions. The term “transforaminal” refers to treatment through the foramina, or the openings in the spinal bones where the nerve roots branch off of the spinal cord.

TFESI may be a viable treatment option if other methods have not relieved your back pain. Here’s what you need to know about these steroid injections and whether they’re right for you.

Types of TFESI

Doctors may categorize TFESI into three types, based on the area of the spine they treat:

  • Lumbar: treats pain in the lower spine
  • Thoracic: targets pain that occurs in the middle curve of the spine
  • Cervical: targets pain in the upper spine, including the neck

The type of TFESI you need depends on where your back pain begins and whether it travels to your arms or legs.

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A doctor may recommend a TFESI to treat inflamed nerve roots that may be causing pain in your spine. These injections include a steroid to help reduce inflammation and related pain.

You may need a TFESI if you have chronic back pain, as well as pain that radiates to your neck, arms, and legs that hasn’t responded to other treatments.

Such injections can help treat pain from several related conditions, including:

Doctors target TFESI to the epidural spaces of the spine. These spaces are located along the outer membrane of your spinal cord. During a TFESI, a doctor will place a needle in these spaces and inject the steroid.

Before the procedure, a doctor will have you lie facedown. They will inject an anesthetic into the treatment area. They will then inject the TFESI.

Once they pull out the needle, they will apply pressure to the area to stop any potential bleeding.

You may go home immediately after the TFESI. Though you may feel discomfort, you may resume your regular activities right away.

Overall, spinal injections like TFESI are safe for most people. Complications are rare, but may include:

You may also want to consider talking with a doctor about the following risks, even though they are uncommon:

TFESI may not be appropriate if you have any of the following conditions:

Epidural steroid injections share a common purpose: to relieve pain. To achieve this, a doctor may consider which location of the spine to treat and which technique to use.

While TFESI directly targets the nerve root openings within the spine’s epidural spaces, interlaminar epidural steroid injections (ILESI) treat these nerves via the spaces between the vertebrae.

A doctor can determine the best way for the injections to reach your spine. One 2022 review suggests that TFESI may be more effective, but more research is needed in this area.

How long does it take for TFESI to work?

A TFESI may work immediately or take up to a few days. The results are highly variable, based on the underlying cause of back pain. Experts estimate that pain relief may last anywhere from 1 week to 1 year per injection.

How often can you get a TFESI?

You may need more than one TFESI or a series of injections to help relieve back pain. While the exact scheduling may vary, experts generally recommend waiting at least 6 weeks between injections.

Is TFESI painful?

It’s uncommon to experience pain from a TFESI. Before injecting a TFESI into your spine, a doctor will inject an anesthetic into the area. This is to minimize any pain from the procedure.

How long does it take to recover from TFESI?

Most people can resume regular activities immediately after getting a TFESI. But you might consider resting for a few days if you have any post-injection discomfort. Regular exercise and physical therapy can also complement the effects of steroid injections.

How much does a TFESI cost?

The cost of a TFESI depends on the facility providing the service, where you live, and your insurance plan. For example, Medicare estimates that the 2022 national out-of-pocket average costs for TFESI at ambulatory surgical centers and outpatient centers were $85 and $149 per injection, respectively.

A TFESI is a steroid injection used to treat inflammation in your spine due to several causes of back pain. While not a cure for the underlying condition, injections like TFESI may help reduce pain and significantly increase your overall quality of life when other treatment measures do not work.

Consider talking with a doctor for more information about TFESI, including the benefits, the risks, and whether you might be a good candidate for this treatment.