Spinal injections have two core purposes:
- To diagnose the source of back pain, or other forms of pain
- To treat pain
In most cases, spinal injections are used as part of a wider-reaching treatment program. This program will typically include a comprehensive exercise program to help you improve and regulate spinal mobility. This is achieved through a combination of strengthening exercises and stretching exercises.
Spinal Injections: Procedure
Spinal injections are carried with the help of x-ray guidance, or fluoroscopy. This x-ray guidance ensures that the medication is correctly placed and also helps to enhance safety during the procedure.
Dye is injected directly before the medication. If the dye fails to flow in the right location, the doctor will reposition the needle and inject more dye until proper flow is obtained. No medication is injected until the right contract flow pattern is in place.
There are various types of spinal injections commonly used today.
Spinal Injections: Types
- Epidural Injections
- Facet Joint Injections
- Sacroiliac Joint Injections
- Provocation Diskography
Epidural Injections
If your pain begins in the spine then radiates to the arms or legs, you might find epidural injections beneficial.
This form of pain often occurs when a nerve is compressed or inflamed, commonly referred to as a “pinched nerve”.
With epidural injections, an anesthetic is injected near the affected nerve. Sometimes, an anti-inflammatory medication is used in the form of a steroid, The needle is positioned in the epidural space. This is tucked away just outside the membrane protecting the spinal cord. This medication serves to lessen inflammation while also addressing the pain. As such, this application is therapeutic.
Epidural spinal injections can also be used diagnostically. A very specific nerve will be targeted to assess whether it’s responsible for the pain. Oftentimes, only anesthetic is required. The doctor will then closely monitor the response to this medication.
Facet Joint Injections
Facet joint injections can also be used both diagnostically and therapeutically.
These injections are placed into facet joints and surrounding areas. Facet joints are small joints between the vertebra at the back of the spine.
This type of spinal injection works well if the source of your pain is due to degenerative or arthritic conditions. It can also be beneficial for treating injuries.
Facet joints can be injected in different ways for diagnostic purposes. Anesthetic is either injected directly into your joint or into the nerves.
Sacroiliac Joint Injections
Sacroiliac joint injections can also be used for diagnostic purposes or therapeutic purposes.
The SI joints are found between the ilium and the sacrum in the pelvic bones. Problems in these joints can cause lower back pain.
Diagnostic injections should dramatically reduce pain in a specific spot.
Therapeutic injections usually include a steroid medication and the aim is longer-lasting pain relief.
Provocation Diskography
Provocation diskography is used purely to diagnose pain. You will experience no pain-relieving benefits.
On the contrary, provocation diskography aims to replicate the existing pain by pressurizing and stimulating the disc through the injection of liquid. Multiple discs are injected to establish which are OK and which have problems.
Are Spinal Injections Safe?
Spinal injection procedures are typically safe procedures.
Any complications are uncommon and usually mild.
Possible side effects include:
- Arachnoiditis
- Avascular necrosis
- Bleeding
- Increased pain
- Infection
- Muscle weakness
- Nerve injury
- Paralysis
- Spinal headache
Types of Spinal Injections
Spinal injections are also known as epidural injections, but why is this?
Well, “epi” is the Greek word for on or upon. The dura is the outer layer of the sac of soft tissue enclosing the spinal cord along with the cauda equina.
A spinal injection, them, is when medicine is injected into the dura.
Types of Spinal Injection
There are 3 main types of epidural injections.
These injections are named for the approach the needle takes to reach the dura.
1. Caudal epidural injection: The spinal canal ends with an opening called the spinal hiatus. Medication is injected via the sacral hiatus into the epidural space
2. Interlaminar epidural injection: The tip of the needle goes in between the lamina – a section of bone in the vertebrae – so it can be delivered directly into the epidural space.
3. Transforaminal epidural injection: The medicine is injected into the nerve roots near the spinal canal
Other Types of Spinal Injection
- SNRB Injection – Selective Nerve Root Block
- MBB Injection – Medial Branch Block
- Facet Joint Injection
- Sacroiliac Joint Injection
SNRB Injection – Selective Nerve Root Block
SNRB’s use local anesthetic injected into the root of a specific nerve. These injections are normally used diagnostically.
SNRBs can be used in conjunction with MRI, a physical exam, and the patient’s history to help identify the pain generator in cases with many areas of spinal compression.
MBB Injection – Medial Branch Block
The facet joints are bony projections that can easily become arthritic over the years.
MBB injections of a local anesthetic into the medial branch nerves can help establish whether the facet joint is responsible for generating the pain you’re experiencing.
Facet Joint Injection
Facet joint injections directly into the facet joint itself are broadly similar to the treatment of arthritis with anti-inflammatory medication or pain-relievers.
Sacroiliac Joint Injection
You have two sacroiliac joints. These connect the sacrum to the ilium; this is a part of your hip joint.
With a sacroiliac joint injection directly into the sacroiliac joints, your doctor can get to the bottom of pain in this area.
What To Do Next
This kind of spinal injection is certainly not the first line of attack if you’re suffering from any form of back pain. Hopefully, you’ll never need to get to the stage of considering spinal injections or surgery.
The problem is, back pain sometimes just won’t go away on its own.
If you’re concerned and you need to speak with a pain specialist in Arizona, call us today at (480) 409-7703.
