How Do Spinal Injections Help?

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A spinal injection is performed to reduce pain and offers the physician important diagnostic information. It involves injecting a local anesthetic and corticosteroid into a specific area of the spine.  In the case of an epidural injection, the medications are injected into the epidural space.  The epidural space is between the protective membrane (dura mater) containing the spinal cord and the bony spinal canal.  When a nerve root block is performed, the medication is injected into the nerve root sheath; a protective membrane (pia mater) covering each nerve root.   

The procedure is performed using fluoroscopic guidance (real-time x-ray).  The doctor places the needle tip at the target area and confirms proper placement of the needle visually and fluoroscopically.   He then injects a small amount of contrast (dye) to ensure correct spread.  Next, a low volume anesthetic / corticosteroid solution is injected.

Outcomes

One of three outcomes can be expected following a spinal injection: (1) no pain relief, (2) pain is relieved for a few hours, or days, and returns or, (3) pain is relieved, returns for a short time period, and then improves again.

• The outcome helps to identify the predominant pain generator, such as a cervical facet joint or lumbar nerve root. 
• When pain is relieved, the patient benefits more fully from physical therapy. 
• Chiropractic adjustments are more effective when guarding is reduced and range of motion is improves.
• Persistent symptoms may need different pain treatment interventions.
• If surgery is recommended, the surgeon may depend on the outcome of previous precision spinal injection(s).

If a spinal injection provides pain relief, additional injections are scheduled.