Did you know that spinal injections are used to both diagnose and treat back pain? Spinal specialists may use a spinal injection to determine the exact location of your pain in order to devise an effective treatment plan. Additionally, spinal injections are also used therapeutically to treat pain and inflammation caused by certain spinal conditions. In most cases, other forms of treatment such as medications and physical therapy, are suggested before trying spinal injections. However, certain cases can benefit on using spinal injections in addition to other more conservative spinal treatments.
As you can probably guess, accuracy is important when injecting anything into the spine. This is why spinal injections are performed using fluoroscopy. Fluoroscopy is a specialized x-ray that allows your doctor to visualize your spine in real-time. Before injecting the medication, dye is injected to make sure it flows in the correct direction. Only once the dye flows in the correct direction is the medication injected. This ensures that the medication is properly administered to the necessary location.
There are different types of spinal injections that your spine specialist may recommend, including:
Epidural Injections
Epidural injections are commonly used to treat radiating nerve pain caused by a compressed nerve. With an epidural injection, an anesthetic and anti-inflammatory medication is injected into the epidural space near the affected nerve. This medication reduces inflammation in order to relieve pressure on the nerve and reduce pain. Epidural injections can also be used to determine which nerve is the source of pain.
Facet Joint Injections
Your facet joints are located towards the back of the spine where each vertebrae meets another. These joints are a common location for degenerative arthritis and injury, which can cause spinal pain. Painful facet joints can be found in the neck, middle back, and lower back. When in the upper or middle back, pain may radiate into the shoulders. When in the lower back, there may also be radiating pain in the buttocks or upper legs. Like their name suggests, facet joint injections are placed in and around the facet joints.
Provocation Discography
This type of spinal injection is used purely for diagnostic purposes. Since this type of injection does not relieve pain, it is rarely used. However, it is sometimes used in preparation for spinal surgery to help the surgeon plan. Provocation discography helps to distinguish a problem disc from a healthy disc. By injecting a liquid into the center of the disc to stimulate it, the type and location of pain, as well as x-ray images of the disc can determine the location and extent of the disc’s problem.
Sacroiliac Joint Injections
Sacroiliac joint injections are similar to facet joint injections, with the exception that they are injected into the sacroiliac joint located between the sacrum and pelvic bones. In most cases, the joint on one side of the body tends to be painful and causes pain to the lower body on the same side. In rare cases, the joints on both sides can be affected. Injecting the sacroiliac joint with anesthetic is generally the best way to diagnose problems with the joint. For therapeutic purposes, a steroid medication is often used to provide more long-term pain relief.
