If you’re plagued with back pain, then you may be a candidate for spinal injections. Learn more about what these injections and their benefits, read this!
If you are one of the millions of Americans dealing with back pain, you know just how debilitating it can be. In fact, back pain is one of the leading reasons Americans visit their doctors every year.
For decades, spinal injections have been one of the most common treatments for back pain on a short-term scale. These injections are a way to relieve radicular pain or pain that radiates from your spine to an arm or a leg. And even though these spinal injections are the most common pain-reliever for this kind of pain, that doesn’t make the idea of them any less frightening for new patients.
If your back pain is becoming unmanageable and your doctor has recommended spinal injections, read on to learn more about what they are and how they benefit the spine.
What Are Spinal Injections?
Spinal injections are a nonsurgical method of treating low back pain.
Doctors use these injections in two ways. First, they can diagnose the source of back, leg, neck, or arm pain. Second, they can relieve that pain.
Most spinal injections are one part of a whole treatment program. Doctors almost always use an exercise program along with spinal injections to improve or maintain spinal mobility and stability through stretching and strengthening exercises.
Doctors perform spinal injections under x-ray guidance. This is fluoroscopy. The presence of the x-ray will confirm that the doctors have their placement correct, ensuring that the medication is delivered safely to the correct site.
In order to do this, doctors inject a liquid contrast dye before the medication. Typically, the contrast will flow into the correct location and it will show up on the x-ray.
If the contrast doesn’t flow, doctors reposition the needle and inject more dye until they find the correct location. They will not inject the medicine until they find the correct contrast flow pattern.
How Do Injections Relieve Back Pain?
Spinal injections can be more effective than oral medication because they place the medicine directly into the place that is causing the pain. Usually, steroid injections deliver an anti-inflammatory solution into the area that is the source of the pain.
But epidural steroid injections work for more than just the lower back region. These injections can also take care of pain in the neck, mid-back, and sciatica. Sciatica pain is leg pain that originates from a pinched nerve in the lower back and radiates downward.
Depending on the type of injection, some of these treatments can be long-lasting while others are only temporary.
However, spinal doctors agree that while the pain relief is only temporary, it does allow the patient to progress in their exercise and stretching program. However, medications might limit your ability to or motivation to do so.
How Injections Diagnose the Cause of Back Pain
Diagnostically, doctors use injections to help figure out which structure in the back is causing the pain. If lidocaine or other similar numbing medicine is used and the patient feels temporary relief after a specific place is injected, doctors can assume that that is the area that is the source of the pain.
When doctors also consider a patient’s history, a physical exam, and all their imaging studies, it gives them a clear picture for diagnostic purposes. It’s very helpful for guiding any further treatment.
Spinal injections can also flush out inflammatory chemicals and proteins that can often cause back pain. Inflammatory chemicals can cause pain and are linked to many common back issues, like lumbar disc herniation and facet joint arthritis.
Steroids delivered through spinal injection also prove to be beneficial by reducing the natural responses of the immune system as it reacts to tissue and nerve damage. Usually, when there is an injury, the body will generate white blood cells and chemicals that attempt to protect the body from infection. However, this process also causes inflammation.
When this process is slowed with steroid spinal injections, the pain is lessened along with the inflammation.
Types of Spinal Injections
There are a number of different kinds of spinal injections available for use. We’ll list a few of them here.
Therapeutic epidural injections can treat pain that starts in the spine and radiates down an arm or a leg. This pain often happens when a nerve becomes inflamed or pinched.
This involves injecting an anesthetic and an anti-inflammatory medication, like cortisone, near the affected nerve. This will reduce the swelling and resolve some or all of the pain.
When doctors use epidural injections for diagnostic purposes, they inject it at a specific, isolated nerve. This allows them to find out if that nerve is the source of the pain.
Doctors watch the immediate response to the injection closely. If the patient experiences pain relief, then that nerve is the primary cause of the pain.
Facet Joint Injections
Doctors use facet joint injections when pain is from degenerative conditions or injury. They’re used to treat neck, middle back, and low back pain, but it doesn’t have to be exclusively limited to the midline spine as they can also cause pain to move into the shoulders, backside, and upper legs.
When using facet joint injections for diagnostic reasons, they can inject anesthetic into the joint or nerves carrying the pain signals away from the joint. If much of the pain is relieved, then they decide that a therapeutic injection would work to provide long-lasting relief.
If the anesthetic injection shows that the specific nerve is the cause of the pain, doctors then work to block the pain signals permanently.
Sacroiliac Joint Injections
Problems in the SI joints can cause pain in the low back, the buttocks, and the leg. Usually, only one joint is painful and can cause pain on one side of the body. It’s less common for point joints to cause pain at once.
The injections for these joints are done very similarly to the facet joint injections.
Spinal injections are generally very safe. If complications do occur, they are mild and self-limited. The risks include:
- Nerve injury
- Avascular necrosis
- Muscle weakness
- Increased pain
These complications are incredibly rare, but it is still important to talk to your doctor about any of your concerns.
Finding the Source
At the end of the day, all anyone with severe back pain wants to do is discover the cause and put an end to it. Spinal injections may not offer every patient complete, long-lasting relief from back pain, however, they can provide temporary relief and the discovery of the root of the issue.
If you believe you might be a good candidate for spinal injections, talk to your doctor.
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