Diagnostic and Therapeutic Spinal Injections
Spinal Injection Procedure
Regardless of its purpose, a spinal injection is delivered directly into the affected area along with a local anesthetic to relieve any discomfort from the actual injection. The anesthesia provides immediate pain relief, while the actual relief from the steroids takes about four to six hours to begin.
Many of these procedures are performed under imaging (X-ray, MRI or CT) guidance to ensure precise delivery of the injection. By injecting medication directly into the affected area, patients can benefit from almost immediate pain relief, as the medication does not have to travel through the body first.
After a spinal injection, patients may experience an initial increase in pain from the actual injection, but this usually subsides within three days. Tenderness and swelling may also occur at the injection site, but this is usually mild.
Epidural Steroid Injections
Epidural steroid injections (ESIs) have been used for decades to temporarily relieve lower back and leg pain (sciatica) in patients with lumbar disc herniation, degenerative disc disease, lumbar spinal stenosis and more. They are also effective for pain in the neck (cervical spine) and mid-back (thoracic spine) as well.
Comprised of cortisone and a local anesthetic or saline solution, ESIs work by reducing inflammation and flushing out particles that cause swelling and pain. Relief from a single injection usually lasts from one week up to a year, depending on each patient's individual condition.
A facet injection is a minimally invasive treatment option for back pain caused by inflamed facet joints, which may develop from spinal stenosis, sciatica or arthritis, and is characterized by neck, arm, low back or leg pain. Each vertebra has four facet joints that connect it to the vertebra above and below. The injection may also be used for diagnostic purposes.
Facet injections are composed of a combination of long-lasting steroid and a local anesthetic that are injected either into the joint capsule or its surrounding tissue. The steroid reduces inflammation and can relieve pain for a few days to a few years. This treatment can be repeated up to three times a year for those patients who experience successful but short-term pain relief.
A nerve block is a treatment that can be used to both treat and diagnose severe pain. It is placed by injecting a substance such as alcohol or phenol into or around the nerve to numb it and interrupt the pain signals sent to the brain. Therapeutic nerve block can treat pain for six to 12 months, and may be repeated as needed. Diagnostic nerve blocks insert an anesthetic for a certain amount of time to determine the source of chronic pain.
Sacroiliac Joint Injections
Sacroiliac (SI) joint injections help doctors diagnose and relieve lower back pain caused by problems within the sacroiliac joint, which connects the base of the spine (sacrum) to the hop. Steroids, along with a local anesthetic and saline solution, are carefully injected into the SI joint to reduce swelling and pain. As with other spinal blocks, if an SI injection successfully improves discomfort, it may be given up to three times per year.
Risks of Spinal Injections
While spinal injections are considered safe for most patients with certain spine problems, there are certain risks associated with this treatment. Some of these risks may include:
- Allergic reaction
- Nerve damage
These risks are considered rare and can be reduced by choosing an experienced doctor to perform your procedure. Patients should discuss these risks and any other concerns they may have with their doctor before treatment.