Therapeutic Injections for Lumbar Disc Disease

Prior to any therapeutic intervention the ultimate objective of treatment, as well as the treatment target, should be clearly identified (1).

There are two objectives in treating patients with spinal disorders- relieve pain and restore function. The efficacy of an intervention depends on it’s ability to achieve these goals. Prior to an intervention, it is important to identify what the treatment targets are; that is, how much should pain be relieved and how much function should be restored in order to determine the treatment a success.

A therapeutic injection, as an isolated treatment, has the potential to provide both long term pain relief (2) and restoration of function. However, many clinicians feel that the primary role of a therapeutic injection is to provide short term pain relief, allowing a window of opportunity for rehabilitation. In evaluating studies on the efficacy of therapeutic injections it is important to identify the treatment targets that were used, specifically whether the goal of the injection was to provide independent therapeutic benefit or to facilitate a conservative care program.

(1) Sackett, et al. Clinical epidemiology. A basic science for clinical medicine. Second edition. Little Brown and Company, 1991.

(2) Derby, et al. Precision percutaneous blocking procedures for localizing spinal pain. Part 2: The lumbar neuraxial compartment. Pain Digest 1993;3:175-88. Ref 19.