What is a transforaminal epidural steroid injection? Targeted relief for sciatica and leg pain

Our newest YouTube Short, posted October 26, 2026, shows a transforaminal epidural steroid injection from start to finish in 30 seconds. Below, we explain what this procedure is, how it differs from other epidural injections, what happens during it, and who may be a candidate. If you have been searching for a sciatica doctor or an "epidural injection near me" in Brooklyn, Staten Island or Manhattan, you will also find where we offer it.

When back pain travels down your leg

The video opens with a simple point: "When pain travels from your lower back down your leg, an irritated spinal nerve may be the cause." Doctors call this lumbar radiculopathy. Most people know it as sciatica or a pinched nerve.

The nerves that run to your legs leave the spine through small openings between the vertebrae. A herniated or bulging disc, or narrowing of the spine (spinal stenosis), can press on a nerve root there and inflame it. Common symptoms include:

• Pain that starts in the lower back or buttock and shoots down the thigh, calf or foot
• Numbness, tingling or a "pins and needles" feeling in the leg
• Leg pain that is often worse than the back pain itself
• Pain on one side, or in some cases down both legs

Our page on lower back pain and sciatica covers the causes in more detail.

What "transforaminal" means

The opening where a nerve root leaves the spine is called the foramen. "Transforaminal" means the medication is delivered through, or right at, that opening. As our Epidural Steroid Injections page explains, an interlaminar injection enters between the vertebrae from the back, while a transforaminal injection targets the opening where the specific nerve exits the spine.

That is why one of our videos is titled "Targeting the exact nerve root causing sciatica." In the newest clip, the narrator says the injection "delivers anti-inflammatory medication directly near the affected nerve." Your physician chooses the approach and the spinal level from your exam and imaging. For a broader look at epidurals, including how long relief may last, read our article on epidural steroid injections for back pain.

What happens during a transforaminal epidural injection

Here is what our videos show, step by step:

1. Evaluation first. A pain physician examines you and reviews your imaging to find which nerve is irritated and at which level.
2. Numbing the skin. In one clip, the physician tells the patient the numbing medicine brings "a pinch and a burn initially." In another, it is "a little bee sting, little stick."
3. Live X-ray guidance. The needle is guided with live X-ray (fluoroscopy). The physician injects a small amount of contrast dye and watches where it spreads to confirm the needle is in the right place before giving any steroid.
4. The medication. The steroid goes in next to the nerve. In two of our clips, the physician asks, "Feel it down the leg?" and the patient answers yes. Tell your physician what you feel at each step.
5. Done. The needle comes out. As the physician tells one patient, "that's it, you're done."

According to our Epidural Steroid Injections page, the visit takes about an hour including recovery time, and you can usually return to light activity the next day.

One side or both sides

Sciatica often affects one leg, but not always. In one of the clips in the More videos section below, the patient "has pain that's in the back and going down both legs," so the physician performs a bilateral transforaminal epidural steroid injection, treating the nerve on each side. In another, a patient with a herniated disc at L5-S1 (the lowest level of the lumbar spine, just above the sacrum) gets two needles at once, "one from each side," both aimed where the nerve comes out.

What a transforaminal epidural can and cannot do

In the words of the newest video, the goal is "to reduce inflammation, relieve radiating pain, and help patients return to daily activities with greater comfort." Another clip adds the aims of improving mobility and supporting recovery.

It is just as important to know the limits:

• It does not push a herniated disc back into place or reverse arthritis. It calms the inflammation around the nerve.
• Some people get good relief, some get partial relief, and some get little or none. No one can promise how much it will help or for how long.
• At Precision Care, relief, when it comes, is used to move your physical therapy plan forward. Strength, mobility and movement habits are what help protect your back over time.

If your pain is mainly in the back rather than the leg, other options may fit better. Our article on how to fix lower back pain without surgery walks through several of them.

Who may be a candidate

A transforaminal epidural is usually considered for sciatica and leg pain from a lumbar disc herniation or spinal stenosis that has not settled with therapy and medication. Before recommending one, your physician confirms where the pain is coming from. Sometimes the source is not obvious. Tests such as EMG and nerve conduction studies can help show whether leg symptoms come from a nerve problem.

Epidural injections are not right for everyone. Tell your physician if you take blood thinners, have diabetes, have an infection or could be pregnant.

Go to an emergency room right away if back pain comes with new weakness in the legs, numbness in the groin or inner thighs, or loss of bladder or bowel control. These can be signs of serious nerve compression.

Related care at Precision Care

Where to get a transforaminal epidural near you

Epidural steroid injections, including transforaminal injections, are performed by our pain physicians with X-ray guidance, and physical therapy follows in the same practice. Our Epidural Steroid Injections page lists our Brooklyn, Staten Island and Midtown Manhattan offices, so call to confirm which location offers the procedure on the day you need. You can request an appointment online or call the office closest to you. An online request is not a confirmed booking until the office contacts you.

For a sciatica doctor close to home, our Brooklyn office serves patients from Gravesend, Sheepshead Bay, Midwood and Bay Ridge, our Staten Island office serves patients from Dongan Hills, New Dorp and Midland Beach, and our Spine & Pain Center is in Midtown East. If your leg pain started after a car accident, our no-fault care page explains how coverage works. Request an evaluation to see whether it fits.

Questions patients ask

Educational only, not medical advice. These videos and this article explain common treatments in general terms. They are not a diagnosis or a treatment plan for you. Results vary from person to person. See a qualified clinician about your own symptoms, and call 911 or go to an emergency room for an emergency.

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