Spinal injections can serve two purposes. Performing a spinal injection can help a doctor diagnose the source of back, leg, arm, or neck pain. If a spinal injection provides pain relief in the injected area, that area is likely the source of the problem causing symptoms. They are also used therapeutically as a treatment to relieve pain.
Spinal injections are typically only one aspect of treatment in an individual’s comprehensive pain management program. An exercise program is commonly included as a simultaneous treatment to improve or maintain spinal stability and mobility.
Your doctor can determine the best method of treatment for your back pain, and your treatment plan may involve spinal injection methods. There are many different types of back pain injections, and having an experienced doctor available to select the right approach is a valuable office. Contact our office today to learn more and to find out how we can help you discover long term relief.
Medications Used
During most spinal injections, a local numbing agent called lidocaine is injected into a specific area of the spine. Lidocaine is a fast-acting drug used more for diagnostic purposes, as the numbing effects wear off in a matter of a couple hours. Bupivacaine is another type of anesthetic that may be used. Its effects come on slower, but are longer lasting, affording more pain relief.
Typically, pain is the result of inflammation. Therefore, cortisone is commonly injected along with the local anesthetic. Cortisone is an effective anti-inflammatory steroid medication. It can give effective pain relief as it is slow-releasing and long lasting. Due to it being slow-releasing, it may take a few days for the effects to be noticed, but the pain relief can last for months in some individuals. In cases of severe pain, narcotic medications such as fentanyl or morphine may also be mixed with the cortisone to achieve the greatest pain relief.
Procedure for Spinal Injections
A doctor will use x-ray guidance called fluoroscopy to perform this procedure. Prior to injection of the medication, a liquid contrast dye is injected. The doctor confirms that the correct flow pattern is achieved before injecting the medication, this confirms correct placement of the medication and improves the patient’s safety. If the contrast dye does not flow in the proper location, the doctor will reposition the needle and inject additional dye until noticing a successful flow pattern.
Types of Spinal Injections
- Epidural Injections: This type of spinal injection is used to treat pain that begins in the spine and radiates to an arm or leg as a result of an inflamed or compressed nerve. During the procedure, typically an anesthetic and steroid medication are injected in the area near the affected nerve to decrease inflammation and pain. The injection is given in the epidural space. This space is between the spinal cord and the inside of the spinal canal and runs the entire length of the spine. When injections are given in the epidural space, the medication can move up and down the spine freely to reach the nerve roots and facet joints near the injection site.
- Sacroiliac Joint Injections: Sacroiliac joints are located between the sacrum and pelvic bones. If an arthritic or degenerative injury or condition is causing pain, it is typically noted in the lower back, buttock and leg. These injections anesthetize the sacroiliac joint using a combination of an anesthetic and steroid medication. The goal is longer term pain relief.
- Facet Joint Injections: Facet joints are located on each side of the vertebrae, joining the vertebrae together and allowing for flexibility of the spine. Facet joint injections are typically used when pain is the result of an arthritic or degenerative injury or condition. They can be used to relieve neck and mid to lower back pain. At times the pain from the mid-spine will radiate into the upper legs, buttocks or shoulders. If these injections provide pain relief, a doctor may take an additional step to permanently block the pain signals from the affected nerve. This would involve damaging the nerve using a “burning” technique, called radiofrequency ablation.
There are also two types of facet joint injections:
- Interarticular – The injection is given directly into the joint to decrease inflammation and block associated pain.
- Nerve Blocks – This type of injection helps a doctor determine if the joint is indeed the source of pain as it blocks the small nerves that connect to the joint.
Valuable Outcomes of Spinal Injections
There are various outcomes that can be expected following a spinal injection. Of course, the most valuable outcome is decreased inflammation and long lasting pain relief. The level of pain relief achieved after an injection helps doctors identify the predominant cause of the pain. When pain relief is achieved, patients further benefit by the ability to tolerate other treatments such as physical therapy or chiropractic adjustments. If symptoms persist after a spinal injection, this outcome would justify the need for additional pain treatment interventions. In the event that surgery was to be recommended, the surgeon may incorporate the results of previous spinal injections when developing an individualized surgical plan.
The extent of pain relief varies among each individual. Steroids used in spinal injections are very strong anti-inflammatory medications, therefore, if inflammation is the cause of the pain, a spinal injection may be a valuable component of a pain management program. The steroid eases inflammation and allows the underlying problem to heal naturally. The body’s ability to heal and correct the underlying disorder will determine if repeat injections are necessary.
If you are wondering whether a spinal injection will work for relieving your back pain, contact our office today. We can explain to you how each spinal injection works and will work closely with you throughout the consultation and diagnostic process in order to determine the best method of pain relief for you. While back pain injections work well for many patients, they are not always the best option. If this is the case, we will find a solution for your back pain that works for your situation.