Injections

Injections are another non-surgical treatment option for alleviating back pain and reducing inflammation. Injections offer temporary pain relief for specific back conditions, allowing patients to regain mobility and strength. Doctors sometimes also use certain types of injections to locate the source of a patient’s pain. Injections are typically not considered until a patient has tried a regimen of anti-inflammatory pain medications and physical therapy.

What types of back conditions are effectively treated with injections?

While injections may be used for a variety of back problems, they are most helpful for radiculopathy and spinal stenosis. Radiculopathy occurs when an injury in the lower back causes a sharp, shooting pain in the legs; this pain is most frequently caused by a ruptured disc. Spinal stenosis is a narrowing in the lumbar spine that causes nerve compression and severe pain in the legs or buttocks.

What types of back injections are available?

  • Epidural Steroid Injections. Before recommending an epidural injection, your doctor will probably order an MRI of your back to diagnose the source of your pain. Epidural injections are typically provided by an anesthesiologist, interventional radiologist, or physiatrist. Your doctor may first give you a sedating medicine and will then use a local anesthetic to numb the area in your lower back. Using a fluoroscope (a real-time x-ray projected on a TV monitor), the doctor will insert a needle into the space between the spine and spinal cord. The doctor then injects a steroid (also called a corticosteroid or cortisone) and anesthetic medicine into this space. The medicine relieves inflammation and pain. Results typically last for several weeks and sometimes up to a year. Because epidural injections may affect the bones and muscles in your spine, patients may receive up to three epidural injections in one year.
  • Nerve Blocks. Nerve blocks are most frequently used to locate the anatomical source of a patient’s back pain. Your physician will inject an anesthetic (usually Lidocaine) near the affected nerves in your back. When your physician pinpoints the source of your pain, nerve blocks typically offer swift pain relief for a few hours. Some types of nerve blocks provide longer-lasting pain relief. They are also used as an anesthetic during surgery.
  • Facet Joint Injections. A mixture of steroids and anesthetic medicine may be injected into the facet joints of the vertebrae to alleviate neck or lower back pain from arthritis and other degenerative conditions.
  • Sacroiliac Joint Injections. The sacroiliac joints are found where the spine meets the pelvis. Doctors may also inject steroids in one of these joints to relieve pain in the leg, lower back, and buttocks.
  • Discography. This type of spinal injection is performed infrequently. It is designed to recreate an individual’s back pain in order to determine which discs are provoking the patient’s pain. It is typically only used to plan surgery.

Spinal injections are generally safe for patients. Risks include bleeding, infection, nerve damage, or headache. Patients may experience soreness at the injection site and other side effects from the steroids.

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