It is typically done with you lying on your stomach. Your blood pressure and oxygen levels will be monitored. In addition to your doctor and the x-ray technician, there will be a nurse in the room at all times. The skin on the back is cleaned with antiseptic solution. A separate area where a good vein is available is also cleaned with antiseptic solution. A small intravenous catheter is placed in the vein. After your doctor has placed the epidural needle near the affected area, he will draw about 20-25 cc of blood from your vein and will then gradually inject the blood.
With a transforaminal epidural steroid injection (ESI), often referred to as a 'nerve block', the needle is placed alongside the nerve as it exits the spine, and medication is placed into the 'nerve sleeve'. The medication then travels up the sleeve and into the epidural space from the side. This allows for a more concentrated delivery of steroid into one affected area (usually one segment and one side). Transforaminal ESIs can also be modified slightly to allow for more specific coverage of a single nerve and can provide diagnostic benefit, in addition to improved pain and function.