Spinal injections are an intermediate step between lifestyle remedies and surgery to treat back pain. If steps such as rest and physical therapy have not relieved a patient’s pain, but he or she is uncomfortable with or not a good candidate for surgery, spinal injections may be a good option.
Types of Injections for Back Pain
Two types of injections are commonly used for back pain. One or the other may be injected at any given time, or a combination of the two may be used. Corticosteroids are powerful anti-inflammatory drugs, whereas anesthetics, also referred to as nerve blocks, cause numbing.
Corticosteroids are an excellent choice when pain is caused by inflammation. This can include:
- Herniated or bulging discs
- Sciatica or other forms of radiculopathy
- Spinal stenosis
Corticosteroids reduce swelling that, in the spine, typically compress nerve roots and cause pain, tingling, numbness or weakness, either in the back or, more often, the arms or legs. Nerve blocks turn off the pain signals, but because they wear off so quickly—in a matter of hours—they are usually used with a steroid.
In addition to the different medications used in spinal injections, these medications can be injected into different places in the spine. The most common areas are:
Epidural space—This is the fat- and blood vessel-filled space between the spinal column and the protective membrane around it, called the dura mater. This is the most common injection site for patients who have spinal issues.
Facet joint—If pain can be pinpointed to a particular facet joint—where two vertebrae meet—an injection can be delivered directly to the joint. Facet joint injections are often performed for degenerative and arthritic conditions of the vertebrae.
Sacroiliac joint—The sacroiliac (SI) joint is where the sacrum—the bottom of the spine—meets the pelvis (ilium). Sciatica is often treated with a SI joint injection.
How the Procedure Is Performed
Spinal injections are very often imaging-assisted. That means spine specialists use an imaging test, such as an X-ray or ultrasound, to guide the injection to the proper place. A contrast dye is usually used in combination with the imaging test for greater clarity.
First, the contrast dye is injected, then imaging is done to see where the contrast dye is flowing. Once the contrast dye is established, the doctor will insert the needle into the right place. Patients may feel some pressure, but the procedure is usually not painful.
Recovery and Results
Spinal injections are outpatient procedures, which can be done in a doctor’s office, with no hospital stay necessary. Patients can immediately resume normal activity.
Most injections bring rapid and long-lasting pain relief. Pain from a herniated disc or other spine condition may subside in a matter of hours and stay away for months. Because of potential complications, such as weakening of bones or connective tissue, most doctors limit steroid injections to two to three per year.
If you have persistent back pain or radiculopathy but are not ready to explore surgical options, request an appointment at Edison Spine Center. Our spine specialists can tell you if a spinal injection may be helpful, and give you options that work for you and your life circumstances.