What are spinal injections?

It is fair to say that if you have a spine, you have experienced back or neck pain. Back pain is one of the most common ailments which prompt individuals to seek a doctor’s care. As understanding about the spine has progressed, so have the spinal treatments available. A spinal injection is a minimally invasive procedure used to treat a wide variety of spinal conditions. Spinal injections are commonly used in both the diagnosis and treatment of back and neck pain. Many patients suffering from debilitating back and neck pain find relief in spinal injections. The experts at BICMD can evaluate patients suffering from neck and back pain through an orthopedic telemedicine visit. Our “Best in Class” surgeons and specialists can help patients across the globe understand and obtain the best diagnostic testing and treatments options available for their spinal condition.

How are spinal injections used?

Spinal injections are used as part of a comprehensive treatment program that usually includes, diagnosis and the treatment for various back and neck conditions. Physical therapy or rehabilitation is an intricate part of the spinal injection process and gives patients a long-term solution to their back and neck pain. Spinal injections are used for one of two reasons:

  • Diagnostically – To diagnose the source or reason for back, neck, leg or arm pain
  • Therapeutically – To treat back, neck, leg or arm pain

What types of spinal conditions can spinal injections treat?

Patients experiencing extreme pain in the neck, back, arms or legs, stemming from a spinal condition can be treated with spinal injections. Some of the conditions that can be treated are:

  • Spinal Stenosis
  • Herniated Disk
  • Bulging Disk
  • Degenerative Disk Disease
  • Sciatica
  • Spondylolysis
  • Nerve Pain
  • Neck Pain
  • Lower Back Pain

How are spinal injections done?

Depending on the type of procedure, patients can remain awake or they can be asleep with needle sedation. General anesthesia is not often warranted for spinal injections and are done for either therapeutic or diagnostic reasons. The process for either injection is the same:

  • The patient is positioned on an x-ray table, either flat on their stomach, or on the side. If either position causes pain, they can be allowed to remain sitting.
  • The area to receive the injection is cleansed and numbed with a local anesthetic.
  • A needle is inserted into the skin and directed toward the spine using a fluoroscopy (live x-ray). The fluoroscopy allows the physician to “see” exactly where the needle is going.

What types of spinal injections are available?

The type of spinal injection that may be recommended by the experts at BICMD will depend largely upon the patient’s history, health and spinal condition. A few of the spinal injections our specialists offer are:

Fluoroscopic (x-ray guided) Epidural Injections:

Why it is used?

Fluoroscopic epidural injections are used to treat an inflamed or pinched nerve in the spine. Pain usually begins at the spine and radiates to the arm, hip or leg.

How it is done?

The epidural space is a canal, formed by surrounding vertebrae that protect the spinal cord. It is located on the outermost part of the spinal canal. A fluoroscopic epidural injection uses a “live” x-ray machine to locate the epidural space with a needle and the inflamed nerve is located. The needle delivers an injection of anesthetic and anti-inflammatory medicine (often a steroid) near the affected nerve.

What is the result?

The medication floods the epidural space and reduces inflammation which in turn, resolves pain.

Facet Joint Injections:

Why it is used?

Can be used for both diagnostic and therapeutic purposes. The nerves between the facet joints are a common cause of back and neck pain. Facet joint injections are often used when pain is caused by an injury, arthritis or from a degenerative spine condition. Long term back pain is often helped by facet joint injections.  They are used to treat neck, middle back, or low back pain.

How is it done?

The facet joints connect the vertebra to the back of each spinal segment and are located between the bones of the spine. The nerve roots pass through the facet joints from the spinal cord to the extremities. The facet joint injections are done in and around the joint.

What is the result?

When used diagnostically, the injection of a numbing agent can help surgeons quickly determine an initial diagnosis. Facet joint injections are one of the few diagnostic methods that can also provide immediate relief for an individual.

When used for treatment, a steroid is added alongside the numbing agent and can provide longer-term relief from back pain. If the numbing agent indicates that the nerve is the source of pain, the surgeon can block the pain signal from the nerve more permanently. This can be done with radiofrequency denervation (see below).

Medial Branch Blocks / Radiofrequency Denervation?

Why is it used? 

Medial branch blocks, also called radiofrequency denervation, is used as a long-term solution to “quiet” or block the nerves causing back, neck or extremity pain.

How is it done?

Medial branch nerves run through the facet joints of the spine. The process begins with a facet joint injection, where a numbing agent is injected in and around the facet joints. The surgeon will typically inject several joints in one procedure. The subsequent procedure, the medial branch block, also called radiofrequency denervation, heats or burns the nerve with a radiofrequency needle.

What is the result?

If the medial branch nerves are the cause of pain, the patient will experience immediate relief after the injection. The subsequent procedure, medial branch block or radiofrequency denervation, creates a lesion on the nerve and the nerve is then unable to send a pain signal to the brain. The medial branch block can last for months or even years. The nerve will usually regenerate, but the pain often does not return.

What are the risks of spinal injections?

The experts at BICMD should be consulted before any spinal injection is considered. Some patients are not candidates for spinal injections due to certain medical conditions. In general, spinal injections have been proven to be safe an effective at treating certain conditions of the spine. There are risks which may include spinal headache from a dural puncture, infection, bleeding, allergic reaction, and nerve damage or paralysis (which is rare).

For more information about spinal injections and how they can help your neck, back, arm or leg pain, or to obtain a 2nd opinion before having a spinal injection, please contact our specialists, by clicking on “Connect With a Doctor.” You will be connected to one of our orthopedic telemedicine experts through our state-of-the-art telemedicine platform.