Just about everyone will experience the discomfort, twinge, ache or soreness of back and neck pain at some point in their lives. It may be due to over-activity, disk injury or degeneration, general wear and tear, spinal stenosis (narrowing of the space around the spinal cord), or scoliosis (an abnormal curve of the spine). Depending on the cause, treatment can range from medications and physical therapy, to braces and surgery. Another option for some patients may be spinal injections.
Spinal injections can be used as a diagnostic tool to identify the source of back and neck pain, or as a treatment to help relieve pain. They are performed using X-ray guidance called fluoroscopy that involves injecting a liquid contrast, or dye, before the medication. The procedure is typically done as part of a comprehensive treatment program that includes stretching exercises to improve or maintain spinal mobility, and strengthening exercises for stability.
Types of Spinal Injections
There are several types of spinal injections. An epidural injection, which is not the same as epidural anesthesia administered before child birth, is given to relieve pain that originates in the spine and then travels to an arm or leg. During this type of injection, an anesthetic and an anti-inflammatory drug, such as a steroid like cortisone, is administered near a nerve that may be inflamed or compressed. An epidural spinal injection also can be done to target a specific nerve to find out if it is the source of pain. In these cases, only an anesthetic is given. If the pain is relieved, then that nerve is causing the pain. If not, there is another source for the pain.
Another type of spinal injection is called facet joint injection. These are frequently used to treat pain associated with injury as well as degenerative or arthritic conditions. These involve injecting anesthetic either directly into the joint or in the nerve that carries pain signals away from the joint. If the pain is relieved, than a steroid may then be injected to provide more long lasting pain relief.
Injecting an anesthetic into the sacroiliac (SI) joint, which is located between the pelvic bones, is done to diagnose SI joint pain. This SI joint injection can considerably reduce pain in a specific location in the lower back, buttock or upper leg. The injection also may include a steroid to provide longer pain relief.
A type of spinal injection called provocation diskography is done to reproduce a patient’s typical pain. It does not relieve pain and could actually aggravate existing back pain. Provocation diskography may be done to help locate the source of chronic back pain that has not improved with conservative treatment. Information from the procedure may be used in planning for later surgical treatment of low back pain.
Spinal injections are typically safe procedures. However, not everyone is a candidate, including those who have an active systemic infection, bleeding disorder, uncontrolled high blood pressure, diabetes, unstable angina, congestive heart failure, or allergies to contrast, anesthetic or steroids. For more information about spinal injections, talk with your doctor at North Fulton Hospital’s Pain and Spine Center or call 770-751-2600 for a free referral to a physician.