- Cervical radiculopathy
- Lumbar radiculopathy
The medicine in the injectionThe medicine could be comprised of a local anesthetic on its own, steroid on its own, or a combination of the two. Steroids are short for corticosteroid, which is a strong anti-inflammatory medication. A contrast dye like an x-ray dye could be added to the injection mix. This dye acts as a guide for precise placement of the needle using image guidance.
Spinal disorders that could benefitProceeding with an injection treatment plan is based on an individual’s unique factors that apply to their condition/state. This decision will be made after consultation, and diagnosis with your doctor, spine specialist, or chiropractor. Healthcare providers recommend conservative treatment first. A treatment plan typically runs around 4-6 weeks. If there is no change or improvement in the individual’s condition from the conservative therapy then injection treatment/s could be recommended. Conditions, where injection/s are used, include:
- Disc herniation
- Facet joint pain
- Failed back syndrome
- Sacroiliac joint pain
- Spinal stenosis
Spinal injection and nerve block differenceSpinal injections are a general term that could mean any type of injection involving the spine. Nerve blocks are a precise type of injection that targets a specific nerve. As the medicine is injected into the target nerve/s, it blocks or creates a blockade of the pain signals being sent from the area (ex. neck, low back, etc.) that is generating the pain.
EpiduralAn epidural means an injection on the dura. The dura is the outermost layer that encloses the spinal cord.
- Caudal epidural:
- Transforaminal epidural:
- Interlaminar epidural:
Selective Nerve Root Block – SNRBThese involve the injection of a local anesthetic onto a targeted nerve. They are typically used for diagnostic purposes. For individuals with multi-spinal compression/s, these combined with:
- Medical history
- Physical exam
Medial Branch Block – MBBThe facet joints are bony projections that connect a vertebral level to the levels above and below. These can become arthritic and is responsible for different forms of back pain. This type of spinal injection is local anesthetic injected on the medial branch nerves. These are the nerves that send pain signals from the facet joint/s. They are useful in determining if the facet joint is the pain generator.
Facet JointThese are injections directly into the facet joint itself. Much like injecting anti-inflammatory and pain meds into a knee with arthritis.
Sacroiliac JointThe two sacroiliac joints help connect either side of the sacrum to the hip joint. Like other joints, these can get inflamed and cause painful symptoms. This is an injection directly into one or both of the sacroiliac joints.
Administration of the spinal injection or nerve blockInjections are only to be performed by doctors trained specifically in spinal injections. Injections are usually performed by an:
- Orthopedic surgeon
Role of these proceduresReasons why an injection could be used:
- Help as a diagnostic to identify the pain generator
- Therapeutically to provide pain relief
- As a prognostic pain predictor of the relief, an individual could expect from a more invasive procedure like nerve ablation.
How oftenA maximum of 6 injections for one year is the recommended treatment protocol. Each injection should be based on the effect/s of the previous injection.
Potential benefitsThe main benefit is to bring pain relief and the ability to function.
Potential risksSpinal injections are considered safe with a low rate of complications. The most common include:
- Facial flushing
- Puncture of the dura
- Nerve damage
Lasting effectsHow long the medicine lasts is different for everyone and comes with variables like:
- Type of injection
- Type of pathology
- How long the symptoms last