Back Pain and Pain Management Injections
Injections for Back Pain & Pain Management
All pain management injections, with the exception of trigger point injections, are done using Fluoroscopic Guidance. Fluoroscopy Guided Injections are done using a visually aided computer system and x-ray technology, which drastically increases the successful delivery of medication to the pain area. Trigger point injections are located through manual palpation of the problem area.
Epidural injections are a common treatment option for many forms of low back pain and leg pain. They are an integral part of the non-surgical management of sciatica and low back pain. The goal of the injection is pain relief; at times the injection alone is sufficient to provide relief, but commonly an epidural steroid injection is used in combination with a comprehensive rehabilitation program to provide additional benefit.
Most practitioners will agree that, while the effects of the injection tend to be temporary – providing relief from pain for one week up to one year – an epidural can be very beneficial for a patient during an acute episode of back and/or leg pain. Importantly, an injection can provide sufficient pain relief to allow a patient to progress with a rehabilitative stretching and exercise program.
In addition to the low back / lumbar, epidural steroid injections are used to ease pain experienced in the neck (cervical) region and in the mid spine (thoracic) region.
Lumbar facet joints are small joints located in pairs in your lower back. These joints provide stability and guide motion in your spine. If the joints become painful due to arthritis, injury, or mechanical stress, they can cause pain in various areas. The lumbar facet joints can cause pain in your lower back, hip, buttock, or leg.
A facet joint injection serves several purposes. First, by placing numbing medicine into the joint, the amount of immediate pain relief you experience will help confirm or deny the joint as a source of your pain. That is, if you obtain complete relief of your main pain while the facet joints are numb, then these joints are likely your pain source. Furthermore, time-release cortisone will be injected into these joints to reduce any presumed inflammation, which can, on many occasions, provide long-term pain relief.
The sacroiliac joint is a large joint in your lower back and buttocks region. When the joint becomes painful, it can cause pain in its immediate region or it can refer pain into your groin, abdomen, hip, buttock or leg. A sacroiliac joint injection serves several purposes. First, by placing numbing medicine into the joint, the amount of immediate pain relief you experience will help confirm or deny the joint as a source of your pain. That is, if you obtain complete relief of your main pain while the joint is numb it means this joint is more likely than not your pain source. Furthermore, time-release cortisone will be injected into the joint to reduce any presumed inflammation, which on many occasions can provide long-term pain relief. Although there are numerous ways to treat sacroiliac joint dysfunction, sacroiliac joint injections work powerfully to reduce your inflammation and they can provide months of relief.
Trigger Point Injections (non-fluoroscopic)
Trigger point injection (TPI) may be an option in treating pain for some patients. TPI is a procedure used to treat painful areas of muscle that contain trigger points, or knots of muscle that form when muscles do not relax. Many times, such knots can be felt under the skin. Trigger points may irritate the nerves around them and cause referred pain, or pain that is felt in another part of the body.
In the TPI procedure, the doctor inserts a small needle into the patient’s trigger point, which is found through palpation of the area. The injection contains a local anesthetic that sometimes includes a corticosteroid. With the injection, the trigger point is made inactive and the pain is alleviated. Usually, a brief course of treatment will result in sustained relief. The treatment is non-invasive and typically takes just a few minutes. TPI is used to treat many muscle groups, especially those in the arms, legs, lower back, and neck.