Spinal Injections

What is Spinal Injection Therapy?

In spinal injection therapy, medications are injected into injured or damaged tissue to support healing, reduce inflammation, and relieve pain.

Injections are a safe and effective treatment to relieve pain. They can also help diagnose the precise source of neck, back, arm, or leg pain.

Injections can be an essential part of an overall treatment plan that includes physical therapy or an exercise program to improve spinal mobility and stability.

What Types of Injections are Available?

There are several types of injections available:

Epidural steroid

The epidural space is between the spinal cord and the spinal column, which protects it. Injections of corticosteroids and anesthetics into the epidural space can soothe inflammation and provide pain relief for damaged, compressed, or inflamed nerves.

Epidural steroid injections can treat pain that starts in the spine and radiates to an arm or leg. This type of pain is often caused by a pinched or inflamed nerve. They are commonly used for conditions that cause lower back pain, leg pain, and sciatica.

The relief gained from epidural steroid injections can help a patient through physical therapy or rehabilitation of an injury or spinal condition.

Epidural injections can also be targeted to an isolated nerve to determine if it is the source of pain.

Facet Joint Injections

Each vertebra has four facet joints that help give the spine stability and range of motion. They can become painful due to arthritis, injury, or stress to the back. Small amounts of a numbing agent and/or steroid medication can be injected into the joints to block the pain.

Facet joint injections are often used to treat pain caused by degenerative or arthritic conditions or injury. They can treat neck, middle back, or lower back pain that can also radiate to the shoulders, buttocks, or upper legs.

Like epidural steroid injections, facet joint injections can help a patient through physical therapy or rehabilitation of an injury or spinal condition. They can also help pinpoint the location of an injury.

Regenerative Injections

Regenerative injections help your body heal itself. There are two types:

Stem cell injections use versatile cells called mesenchymal stem cells to encourage tissue growth and repair. Mesenchymal stem cells can transform into other, specific types of cells to speed the regrowth and repair of tissue. They can also regulate nearby cells to trigger healing.

Platelet-rich-plasma (PRP) injections use concentrated growth factors taken from your own blood to encourage healing, reduce inflammation, and increase circulation.

Regenerative injections can decrease pain and boost healing from:

Acute injury
After surgery
Degenerative disc disease
Osteoarthritis
Tendon injuries

What Can an Injection Treat?

Injections are often used to relieve pain in the back, neck, hip, shoulder, buttocks, and upper leg caused by various conditions, including:

Arthritis
Bone spurs
Degenerative disc disease
Herniated disc
Sciatica
Spinal injury

Procedure

Injections are typically performed without sedation, but it can be given if needed. You should plan to have a friend or family member drive you home after your injection.

You’ll lay on a procedure table, and the skin in the area of the injection will be cleansed.
You’ll have a small amount of a topical anesthetic applied to the area.
Using a special type of X-ray called fluoroscopy as a guide, your physician may inject a small amount of dye to help determine the placement of the medication.
The medication is then injected.
After the injection, you will rest in a recovery area for about 30 minutes.

After the injection, you should avoid strenuous activities and driving for the rest of the day.

You might notice a slight increase in pain as the numbing wears off before the medications take effect. A cold pack can relieve discomfort at the injection site for the first few days.

Risks

Spinal injections are typically safe. Complications are rare but may include:

Arachnoiditis (inflammation of a membrane protecting the nerves of the spinal cord)
Avascular necrosis (loss of blood supply to bone tissue)
Bleeding
Increased pain
Infection
Muscle weakness
Nerve injury
Paralysis
Spinal headache

In addition, the steroids used in some injections may cause:

Diarrhea
Facial flushing
Increased appetite
Increased blood sugar
Menstrual irregularities
Nausea

Are Injections Right for Me?

Your doctor will evaluate your condition and discuss your options with you. First, you may need to have a physical exam, discuss your medical history, and undergo testing such as X-rays or an MRI.

You may not be a good candidate because of: