To help patients suffering from severe cases of chronic pain, spinal injections are used for both diagnostics and therapeutic purposes. An injection can help determine the source of the pain and it is often used as a treatment for chronic pain, particularly chronic back pain. There are four main types of spinal injections that treat different types of pain. Each type of injection is part of a larger treatment plan that includes specific exercises and stretches to secure the effectiveness of the treatment.
Spinal injections relieve pain and improve movement by reducing inflammation. Injections are conducted under X-ray guides called fluoroscopy. A fluoroscopy is an imaging technique used to study the movement of body structures. A continuous X-ray is displayed on a monitor for a healthcare practitioner to ensure the proper placement of the injection. Dyed liquid is used prior to the medication to make sure that the medication will flow in the right direction once it is injected. Medication is not injected until the proper contrast flow is achieved.
Epidural injections work to treat sciatica pain, or pain that stems from the spine and reaches to extremities such as the arms or legs. Arm or leg pain frequently is caused by nerve inflammation or compression. A compressed nerve is colloquially referred to as “pinched nerve.”
An epidural injection uses a steroid such as cortisone. The injection is placed near the affected nerve to reduce inflammation and ease the pain. Sometimes, an epidural spinal injection is administered by a specific and isolated nerve to test if that is the nerve responsible for pain. This method would be considered a diagnostic one.
If pain is believed to be caused by degenerative or arthritic conditions or from a physical injury, such pain can be treated with facet joint injections. Neck pain, middle and low back pain can all be treated with these injections, which are administered to the facet joints in the spine.
To diagnose the source of pain, the facet joints can be injected following two methods: anesthetic can be injected directly into the joint or the nerves carrying pain signals from the joint can be numbed.
The sacroiliac joint (SI joint) connects the pelvis to the spine. This type of injection eases problems with the SI joint, which is sometimes the source of low back, buttock, and leg pain. Usually, only one of the SI joints in the body is problematic and causes pain to one side of the lower body, although it is possible for both SI joints to cause pain at the same time.
Spinal injections are outpatient procedures that can be performed in an office setting. Still, there are certain things you should do to come prepared for the visit. At times, you may be asked to refrain from eating or drinking for 6 hours before the procedure. Your pain management physician should also be informed of any medications you are taking. It is also a good idea to have someone available to drop you off and pick you up from the procedure.