Back or neck pain can be debilitating to the point that you cannot perform your daily routines without being negatively impacted. Pain management methods like medication, rest, or ice and heat therapy sometimes do not relieve your pain and it is time to seek other treatments. An experienced specialist like Dr. Charla Fischer in New York City might recommend spinal injections if conservative treatments are unsuccessful.
Spinal injections are considered a low risk, minimally invasive treatment for back pain. They are typically administered in a medical clinic, surgery center, or hospital. The injection consists of a mixture of a steroid and a numbing agent that is inserted directly into the area of the spine that is causing pain. Sometimes it may be tricky to find the exact source of pain, so injections may be used as diagnostic tools to help located the source or as injection therapy for spinal pain. The goal of the medication is to reduce inflammation and discomfort.
There are several main types of spinal injections used to provide pain relief. The most common include:
- Epidural injection: these injections are most often administered to treat lower back or leg pain, although they may also be used for cervical or thoracic pain. The effects vary widely among patients, with some getting relief for only a week but others finding relief for up to a year. Dr. Fischer usually limits the number of epidural injections per patient to three over a year period.
- Selective nerve root block: these types of injections target inflamed nerve roots that are compressed and causing pain. It can be difficult to find the specific nerves that are inflamed, so selective nerve root blocks can be used to help identify the pain source. If one injection does not aid the patient, another one may be scheduled to inject in a different spine location to continue to seek the pain source. Up to six selective nerve root block injections can be given to the same area of the back per year.
- Facet joint block: the spine is made up of paired joints called facet joints that contain cartilage that keeps the bones from rubbing against each other when you move. The facet joints also contain nerves that may cause pain if the facet joint is damaged in some way. Damage can occur with aging or an injury. Facet joint blocks are injections into the specific facet joint causing pain and can be done up to three times a year.
- Sacroiliac joint block: another kind of joint in the spine is called a sacroiliac joint that connects the bottom of the spine to the hips. Pain may arise if the joint is injured or damaged. Sacroiliac joint blocks can be given up to three times a year and are usually effective for up to four months.
The reason that spinal injections are given only a certain number of times per year is that overuse of steroids may cause side effects, such as thinned skin, insomnia, high glucose levels, or even bone or muscle weakening. Dr. Fischer believes that administering spinal injections over a safe time period allows the body to adjust. If you are experiencing back pain, consider speaking to a medical professional to see if spinal injections can help you.