The Science Behind Cervical Transforaminal Epidural Injections and Who is a Good Candidate

Chronic neck and arm pain can significantly disrupt daily life, especially when caused by nerve compression in the cervical spine. One advanced, targeted treatment option for addressing this pain is the cervical transforaminal epidural steroid injection (TFESI). This procedure is both diagnostic and therapeutic, offering relief by delivering medication directly to the inflamed nerve root.

Understanding the Anatomy and the Cause of Pain

The cervical spine consists of seven vertebrae (C1–C7) and houses nerve roots that branch out through small openings called foramina. When a nerve root is compressed or irritated (often due to a herniated disc, bone spur, or spinal stenosis) it can lead to symptoms such as:

• Neck pain

• Radiating arm pain

• Numbness or tingling

• Muscle weakness

What Is a Cervical Transforaminal Epidural Injection?

This minimally invasive procedure involves guiding a thin needle to the area of the affected nerve root via the foraminal opening. Using fluoroscopic (X-ray) guidance, a steroid and local anesthetic are injected into the epidural space surrounding the nerve.

The steroid reduces inflammation, while the anesthetic can provide immediate yet temporary pain relief. The targeted nature of the injection allows for more precise delivery compared to interlaminar or caudal approaches, which may not reach the specific nerve root as directly.

What Does the Science Say?

Research supports the efficacy of cervical TFESIs for short- to intermediate-term relief from radicular pain. A 2021 review in Pain Physician noted that TFESIs can provide significant improvement in pain and function, especially in patients with confirmed nerve root compression on imaging.

While the procedure carries a small risk of complications (e.g., bleeding, infection, or nerve damage), proper technique, imaging guidance, and physician experience significantly reduce these risks.

Who Is a Good Candidate?

Cervical TFESIs may be appropriate for patients who:

• Have persistent neck or arm pain despite conservative treatments such as physical therapy, NSAIDs, or oral steroids

• Show evidence of nerve root compression on MRI or CT scans

• Experience symptoms consistent with radiculopathy (radiating pain, numbness, or weakness)

• Are seeking diagnostic clarity regarding which nerve root is involved

Patients who are not ideal candidates may include those with active infections, bleeding disorders, or allergies to the medications used. Pregnant women and individuals with severe spinal instability may also require alternative approaches.

Ready to Find Neck Pain Relief?

Cervical transforaminal epidural injections are a scientifically backed option for patients dealing with cervical radiculopathy. By targeting the affected nerve root directly, they offer a focused approach to pain management and can be part of a larger treatment plan that includes rehabilitation and long-term spine care.

If you're experiencing persistent neck pain, contact Dr. Jacob T. Rohrs to schedule a consultation and find out if a cervical TFESI is right for you. Visit our office in Scottsdale, Arizona, or call (808) 645-4080 to book an appointment today.