Pain Management & Injection

1Spinal injections are used to deliver a combination of local anaesthetic and steroid into or near the spine to ease back pain and improve function, and sometimes to help identify the source of back pain by numbing certain areas. Injections into or near the spine help deliver pain-reducing medicines directly to the source of pain and are usually recommended for relief of back pain or sciatica (shooting pain down one or both of your legs). The effects of a successful spinal injection can last from a few weeks to several months.

Medications injected include:

  • Bupivacaine or marcaine – a slower acting and longer lasting local anaesthetic.
  • Cortisone – a strong long lasting anti-inflammatory. It can take several days to work, but its effect can last for months.

Injection techniques used include:

Epidural

An epidural injection is delivered into the epidural space of the spine to provide temporary or prolonged relief from pain or inflammation. The epidural space is located outside the dural membrane. Anaesthetics and anti-inflammatory medications are typically delivered in an epidural injection. The injection may reduce pain and swelling in and around the spinal nerve roots, as well as around damaged nerves which in time may heal.

Spinal nerve root block (periradicular)

A nerve block is the induction of regional anaesthesia by preventing sensory nerve impulses from reaching the spine. It is accomplished by injecting a long acting local anaesthetic solution around the nerve. Sometimes steroid is injected also to help relieve inflammation surrounding the nerve. Nerve blocks are most often used to produce anaesthesia in specific areas of the body.

Facet joints

Facet joints (also called zygapophyseal joints) are small joints of the spine that provide stability and help guide motion. They are found in the neck (cervical), upper back (thoracic) and lower back (lumbar). They can become painful as a result of arthritis, injury or mechanical stress. However, this is not necessarily the sole cause of long term back pain.

Two nerves called “medial branches” supply each facet joint. These nerves carry pain signals to the spinal cord and these signals will eventually reach the brain.

The facet joints and/or medial branch nerves can be injected with a local anaesthetic and/or steroid.

Sacroiliac Joints

Sacroiliac (SI) joint injections are diagnostic injections that provide an attractive, objective means of diagnosing joint pain.

 

Pain Management

You should take your routine medications, but stop any pain relievers or anti-inflammatory medication for the day.

Please advise staff if you are:

  • Taking blood thinners (especially warfarin and clopidogrel)
  • Diabetic
  • Pregnant (or any chance of you being pregnant).
  • Allergic to iodine, betadine, shellfish, local anaesthetics, or steroids.
  • Unwell (especially if you have an infection)

Staff may advise you to:

  • Fast
  • Take your usual medications (apart from those mentioned above)
  • Arrange for someone to accompany you home

Please bring any relevant films and your referral to your appointment.


The back injections are done under a dedicated CT fluoroscopy unit available with our 64 slice CT scan.The injection will be performed by our radiologist who is specially trained to do so and has vast experience in the same.

You will be lying down on your stomach/face down with your back exposed. The skin on your back will be cleaned with an appropriate antiseptic solution. A small needle will be used to inject some local anaesthetic under the skin. This will sting for a few seconds before causing numbness.Under fluoroscopy guidance, a thin spinal needle will be inserted in your back. When the needle is in the right spot, a small amount of xray dye will be injected to confirm a correct location. Therafter,a combination of anaesthetic and steroid will be injected in the spot.The needle will then be taken out and a sterile dressing will be put at the needle entry point.

The procedure usually takes 15 to 20 minutes.


You will be required to wait in the practice for 30 to 45 minutes, depending upon the nature of the examination.

You may experience numbness or tingling in your legs ,which is usually transient. Other transient side-effects of a spinal injection include the following:

  1. Loss of leg strength, muscle spasms and inability to pass urine – this wears off with the anaesthetic.
  2. Pain and tenderness in back or leg – the pain may get worse before it improves.
  3. Difficulty in sleeping – this usually passes after the first night.
  4. High blood sugar levels – if you have diabetes, you will be carefully monitored after the injection, but you must also keep checking your sugar levels at home.
  5. Feeling weak, dizzy or faint – the steroids can cause a drop in blood pressure.
  6. Swelling in your hands, feet or joints – this is caused by fluid retention

The following complications of a spinal injection are very rare but can be serious.

  1. Headache – the needle can cause spinal fluid to leak into your spinal cord, resulting in severe headache lasting for up to a week.
  2. Bleeding – the needle can nick a blood vessel and cause blood to leak around your spinal cord and you may need further hospital treatment.
  3. Infection – bacterial infection in the spine can be very serious and will require antibiotic treatment.
  4. Loss of feeling – inflammation and damage to nerves can cause patches of numbness lasting up to three months.

However these complicatins are extremely rare and have an incidence of less than 1% in our radiologists experience.


(X-rays) are bulk billed where ever medicare rebates are applicable. We charge a small gap fee on CT scans, ultrasound and imaging guided interventions. Depending on the type of test you are having, any costs will be explained. Your examination will be Bulk Billed if you’re on a valid Health Care Card or Pension Card. Please feel free to discuss any issue related to billing, claims and expenses with our helpful, caring staff.
Wollongong Diagnostics expects that you settle payment on the same day the service is provided. Our staff will notify you of this requirement when you arrive for your appointment. Please discuss with our staff before you arrive for your appointment.
At Wollongong Diagnostics, you can settle your account using cash, Eftpos or credit card as per your convenience. If for any reason, you are not able to do the payment on the same day, please contact (02) 4226 1777.


Wollongong Diagnostics is committed to providing the very best in radiological services to its patients. Part of this commitment includes ongoing testing and servicing of all diagnostic radiographic equipment within the practices, a continual review of the protocols used and quality assurance testing. In addition, the equipment manufacturers carry out regular scheduled servicing on behalf of Wollongong Diagnostics.
All radiographic equipment is registered with the Environment Protection Authority (EPA) in NSW and ACT Radiation Council. Wollongong Diagnostics complies with the Radiation Control Act 1990 established by the EPA.
We are fully equipped with Bismuth breast and eye shields to minimise radiation to breasts and eyes.