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What is a spinal injection?
Your doctor may advise a spinal injection to decrease your pain and improve your function. This procedure may help alleviate pain by decreasing inflammation (edema and tissue injury). Also, an injection may anesthetize an area in your back, providing your doctor with information about the source of pain. The choice of injection will depend on your complaints and your doctor's physical examination findings.
Anatomy of your spine
- Vertebrae are cube-shaped bones that make up your vertebral column.
- Discs are spongy structures between the rectangular shaped vertebra. A herniated or worn out disc may be a source of pain.
- Facet joints are small joints at the posterior side of the spine. They help with the movement among vertebrae. When irritated or inflamed, they may be a source of pain.
- Spinal nerves are branches of the spinal cord that exit the spinal column. They carry signals that control the movement of your muscles and carry the senses to your legs and arms. When these nerves are injured or inflamed, they may be a source of pain.
- Epidural space circumscribes the sheath (dura) that covers the spinal nerves. Delivering the anti-inflammatory drugs to the epidural space may decrease nerve inflammation.
- Sacroiliac (SI) joints consist of the lower segment of your spine (sacrum) and pelvic bone (ilium). The inflammation in these joint may result in low back pain, buttock pain, and other types of pain.
Getting Ready For an Injection
Spinal injections are carried out on an outpatient basis. You will be asked a few questions regarding your general health condition. You also will be given instructions on how to prepare for the procedure.
- Create a list of drugs you are using (e.g., medicine for diabetes, blood thinners, pain killers such as aspirin or ibuprofen, over-the-counter drugs, herbal medicine, and dietary supplements). You may have to discontinue some of them before the procedure—please consult our medical staff. In general, patients continue drugs necessary for their health (e.g., thyroid disease and antihypertensive medication). Acetaminophen does not interfere with the procedure; you are allowed to use it.
- Create a list of substances of which you are allergic (e.g., drugs, latex, and contrast material).
- Come to your appointment with your usual pain. This will enable a better understanding of whether the injection has blocked your pain. For this reason, the spinal injections are occasionally called "blocks".
- Come with someone who can take you home after the procedure.
- You may be required to stop eating and drinking at least six hours before the procedure—please consult our medical staff.
- If you have upper respiratory tract infections such as flu or common cold, it is crucial that you inform your doctor. Your doctor may choose to postpone the procedure.
Risks and Complications
All medical procedures have risks and benefits. Spinal injections have some risks and complications, which include:
- Spinal headache
- Bleeding (rare)
- Infection (rare)
The procedure
The procedure is usually short. Your skin will be cleaned with a sterile solution and sterile drapes will be in place. A conscious sedation—a relaxing agent while you remain awake—may be applied if deemed appropriate by your doctor. Local anesthetics may be used near the injection site.
In order to determine the precise location of the needle, fluoroscopy is typically used. Contrast dye may be injected to verify correct position of the needle. Local anesthetics (e.g., lidocaine, bupivacaine, etc.) and/or steroids to decrease the inflammation are then injected. A small dressing is applied on the injection site.
After the procedure
- You may be connected to a monitor to check your vitals. In general, you will need assistance from someone to take you home.
- You may apply ice over the injection site for 10-20 minutes if you have pain. You may take a shower; however, avoid pools and hot tubs for 24-48 hours after the injection. If sedation was applied, you should not drive for the next 24 hours.
- You are advised to rest on the day of the injection, and you may return to your normal daily activities the next day.
- You may begin your custom exercise program and physical therapy program within one week, or you may continue with your previous programs.
- It takes some time before the drugs affect on the inflammation. Meanwhile, you may experience some transient side effects, such as: Increase in pain that will dissipate in a few days; Headache; Difficulty in sleeping; Flushing and Hiccups
- You will have a control visit in 1-3 weeks. If you experience any of the following symptoms, contact your doctor before the control time: Severe pain or headache; Fever or chills; Loss of urinary or fecal continence (inability to hold urine or stool); Progressive weakness and Redness or swelling