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Back Pain Treatment: Spinal Injections

Part 2 of 4

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Spinal Injections
With most spinal injections, a local anesthetic called Lidocaine (also known as Xylocaine) is used to numb the injection site. A steroid medication called a corticosteroid is also commonly injected along with the anesthetic in order to reduce inflammation in the affected areas. 

Facet Joint Injection
When back pain originates from the facet joints (located in each side of the vertebrae), a specific type of injection called a facet joint injection may reduce inflammation and provide pain relief. Doctors use fluoroscopy to ensure the needle is correctly placed before the medicines are injected. Fluoroscopy is a special type of x-ray used to project live images onto a monitor (TV screen).

facet joints

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Epidural Steroid Injection (ESI)
During an ESI, medications are injected into the “epidural space”. The epidural space is the area between the spinal sac and spinal canal, which runs the length of the canal. As the medicine is injected into the epidural space it coats the nerve roots and outside lining of the facet joints.

vertebral body, labeled structures, color drawing

 

 

Updated on: 02/18/10
Thomas G. Lowe, MD
This article brings a number of treatment options for the patient with a back problem to ask his or her healthcare provider about. The important fact to remember is that almost all of the causes of back and/or nerve root pain will respond to the nonsurgical treatments discussed in this article.

Epidural steroids can be effective in alleviating leg pain resulting from a herniated disc or narrowing of the spine from arthritis as long as the pain has not been present for more than 3-6 months. They are often prescribed in a series of three - 2-3 weeks apart. Although most herniated discs will resolve with time without surgery (6 weeks - 3 months), some patients will require surgery sooner because of severe pain or weakness of the leg resulting from compression of the nerve by the herniated disc. The same is true of laminectomy procedures for spinal stenosis. Spinal fusion is a major surgical procedure designed to relieve mechanical back pain resulting from arthritis by eliminating movement between two or more vertebrae. It should only be considered after a 3-6 month period of nonsurgical treatment options discussed in the article.

This article should inform patients with back pain that there are a number of treatment options available that should be discussed with the treating physician in order to expedite a successful recovery.

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