Injecting medicines is one of the widely used methods in attempt to relieve the back pain and inflammation. Often it proves helpful for some people. The injections are commonly consisting of a steroid and a numbing medicine. It is not beyond the realms of possibility that the injection may relieve the painful symptoms completely and for a prolonged period of time, however, it is worth noting that not everyone gets the same relief.
Types of Injections
Back injections are mainly used to help treating two major back pain problems: radiculopathy and spinal stenosis. In certain occasions medics also use injections for several other types of back pain. The back injections are also used sometimes for diagnostic purposes, i.e. to help find out what’s causing the pain.
Radiculopathy refers to inflammation or damage to a nerve usually in the neck or the low back. The origin of the problem is typically the place where the nerve exits the spine. Talking about radiculopathy, the distinctive symptom would be sharp pain shooting from the lower back down into one or both legs or from the neck into the arm. A herniated disc may very well be a cause for radiculopathy.
With spinal stenosis, the lower spinal canal (the foramina through which the nerves are passing) becomes narrowed. As a result, it compresses the nerves inside. This usually causes pain in the buttock or leg and may or may not be accompanied by back pain. In spinal stenosis pain often becomes worse with activity. Sometimes it may lessen when you lean forward.
Medications for back pain can be injected into the area around the inflamed or damaged nerves. There are several kinds of injections typically used, including: epidural, nerve block, discography.
Epidural Injections in Treating Back Pain
The meaning of epidural is “around the spinal cord.” Traditionally, epidural injections are administered by a doctor, in the doctor’s office or the hospital.
Anaesthesiologists, physiatrists, or interventional radiologists with special training are also among the medical professionals administering the epidural injections.
Before the procedure, you are likely to be sent for an imaging test. This may involve a CT scan or an MRI of the back. The test allows the medics to identify possible causes of back pain.
After the scan, at the doctor’s office, you will be placed face down on a table or special bed. The doctor might give you a sedating medication, although the sedation is usually unnecessary. Here are typical steps of the procedure:
- The skin will be cleaned and the anaesthetic will be injected to numb the area.
- Medics then will insert a needle through the skin toward the spine.
- Using a machine that produces live X-ray video called fluoroscopy, the doctor will carefully move the needle between the bones of the spine.
Using a contrast dye, the doctor will confirm the needle is placed in the epidural space. That’s the space between the dura matter (fibrous outer covering) of the spine and the spinal cord inside it. After ensuring that the needle is in position, the doctor will inject a solution into the epidural space. The solution contains a steroid medicine, also called corticosteroid, usually together with an anaesthetic medicine.
The epidural injection is usually not painful because of the numbing medicine used at the start. Many people will experience some moderate tenderness for up to a few days after the injection.
Nerve Blocks Treating Back Pain
Performing a nerve block, medics inject the tissues near the nerve with a numbing medicine, or anaesthetic. Lidocaine is the most common anaesthetic used. After the injection, the patient will usually rapidly experience numbness with near-complete pain relief. The numbness wears off, however, after several hours.
Some doctors use nerve block injections for diagnostic purposes. If that was the aim of the procedure, you’ll be asked which injection causes the pain to cease. That nerve may then be chosen for an epidural injection with both steroid and anaesthetic medicine. Or it may help the doctor to determine if some other treatment is more suitable for this particular condition. Nerve blocks are also often used as anaesthesia during surgery or other medical procedures.
Discography Injections as a Diagnostic Procedure
In some patients back pain is caused by a damaged disc between spinal bones, or vertebrae. Performing discography, doctor injects contrast dye directly into the intervertebral disc. The medics then observe the disc on an X-ray video screen. If contrast dye starts leaking out of the disc, and the patient’s usual back pain reoccurs, the test is considered positive. Clinical studies, however, have not reflected that discography is always a helpful test.
Injections for Back Pain: Risks
Mild soreness or pain at the site after an injection for back pain is common. Headache, nausea, and vomiting sometimes may also occur. On rare occasions, back injections cause significant bleeding or infection. All the risks involved in the procedure should be thoroughly discussed with the doctor before administering an injection.